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Individual

DR. JASON KLEVANSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
3455 LAWRENCEVILLE HWY, LAWRENCEVILLE, GA 30044-4101
(770) 921-1115
Mailing address
3455 LAWRENCEVILLE HWY, LAWRENCEVILLE, GA 30044-4101
(770) 921-1115

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012805
GA
122300000X
Dentist
DS028119L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
157593
UNITED CONCORDIA
PA
Enumeration date
06/08/2005
Last updated
07/21/2022
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