# JDM DENTAL, PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154605384
- **Authorized official:** DR. JEFFREY D MAURER (DENTIST)
- **Authorized official phone:** (804) 748-8677

## Contact information

- **Practice address:** 4516 W HUNDRED RD, CHESTER, VA 23831-1740
- **Practice address phone:** (804) 909-5709
- **Practice address fax:** (804) 748-8053
- **Mailing address:** 4516 W HUNDRED RD, CHESTER, VA 23831-1740
- **Mailing address phone:** (804) 909-5709
- **Mailing address fax:** (804) 748-8053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401411812 | VA | Yes |

## Other

- **Enumeration date:** 10/06/2011
- **Last updated:** 10/06/2011