Keith Jackson, Tayler Yvette

Keith Jackson, Tayler Yvette is an individual health care provider with primary practice located at 5140 Jimmy Lee Smith Pkwy , Hiram GA 30141-2745. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is her primary health care specialty. Keith Jackson, Tayler Yvette can be contacted via phone (770) 439-1038.

Contact Information

Primary practice address
5140 Jimmy Lee Smith Pkwy Hiram GA 30141-2745
Phone: (770) 439-1038
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DEN1002033 District of Columbia
Dental Providers / Dentist 122300000X DN122496 Georgia

Profile Details

NPI number 1841848421
LBN Legal business name Keith Jackson, Tayler Yvette
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2019
Last updated Sep 24th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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