| Dental Wellness Center Of Jesup | |
|
135 Peachtree St Jesup GA 31545-0211 | |
| (912) 665-2792 | |
| (888) 289-4301 |
| Full Name | Dental Wellness Center Of Jesup |
|---|---|
| Speciality | Dentist |
| Location | 135 Peachtree St, Jesup, Georgia |
| Authorized Official Name and Position | William Howard Trout (MANAGING PARTNER) |
| Authorized Official Contact | 9126652792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Wellness Center Of Jesup 135 Peachtree St Jesup GA 31545-0211 Ph: (912) 665-2792 | Dental Wellness Center Of Jesup 135 Peachtree St Jesup GA 31545-0211 Ph: (912) 665-2792 |
| NPI Number | 1538457387 |
|---|---|
| Provider Enumeration Date | 07/14/2011 |
| Last Update Date | 07/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538457387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | GA 10747 (Georgia) | Primary |
Gary A. Lewis, D.m.d., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Drennon Dr, Jesup, GA 31545 Phone: 912-427-7072 Fax: 912-427-9350 |