Organization
JERRY G. MAYES, PSC
Active
Other names
London Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY MAYES DMD (OWNER DENTIST GENERAL)
(606) 878-7251
Entity
Organization
Contact information
Practice address
828 SOUTH MAIN STREET, LONDON, KY 40741
(606) 878-7251
(606) 878-1285
Mailing address
828 SOUTH MAIN STREET, LONDON, KY 40741
(606) 878-7251
(606) 878-1285
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45000395
EPSDT
KY
05
—
61900593
—
KY
Enumeration date
03/06/2007
Last updated
08/06/2008
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