Individual
DR. RICHARD ALLEN JETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
230 WARREN PL, CAMPBELLSVILLE, KY 42718-9618
(270) 789-2087
Mailing address
230 WARREN PL, CAMPBELLSVILLE, KY 42718-9618
(270) 789-2087
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
5355
KY
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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