Individual
DR. JOHN BENJAMIN JETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2329 DEVINE ST, COLUMBIA, SC 29205-2431
(803) 799-3368
(803) 799-3504
Mailing address
2329 DEVINE ST, COLUMBIA, SC 29205-2431
(803) 799-3368
(803) 799-3504
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2804
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z28042
—
SC
Enumeration date
08/22/2006
Last updated
07/08/2007
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