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Organization
JERRY G. MAYES, PSC
Active
Organization
JERRY G. MAYES, PSC
Active
Other names
London Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY MAYES DMD (OWNER DENTIST GENERAL)
(606) 878-7251
Entity
Organization
Contact information
Practice address
828 SOUTH MAIN STREET, LONDON, KY 40741
(606) 878-7251
(606) 878-1285
Mailing address
828 SOUTH MAIN STREET, LONDON, KY 40741
(606) 878-7251
(606) 878-1285
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45000395
EPSDT
KY
05
—
61900593
—
KY
Enumeration date
03/06/2007
Last updated
08/06/2008
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