Individual
JAYCE MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
30 S CLAYTON ST APT 4306, LAWRENCEVILLE, GA 30046-5782
(516) 884-5418
Mailing address
30 S CLAYTON ST APT 4306, LAWRENCEVILLE, GA 30046-5782
(516) 884-5418
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122558
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Enumeration date
11/29/2021
Last updated
12/27/2021
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