Individual
DR. JERRY JASON THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8200 MALL PKWY, STE 200, LITHONIA, GA 30038-6983
(770) 484-7645
(770) 484-7745
Mailing address
4724 EAGLES RIDGE LOOP, LITHONIA, GA 30038-3537
(770) 484-7645
(770) 484-7745
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
2901018052
MI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN012642
GA
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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