Individual
DR. JERRY B BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S, M.S.
Contact information
Practice address
683 ROBINSON RD, JACKSON, MI 49203-1155
(517) 787-0417
(517) 787-5536
Mailing address
505 N JACKSON ST, JACKSON, MI 49201-1266
(517) 748-5500
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
JB008016
MI
Other
Enumeration date
09/14/2006
Last updated
12/23/2021
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