Individual
DR. HENRY JACKSON PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
378 SAVANNAH AVE, STATESBORO, GA 30458-5163
(912) 764-4403
Mailing address
7059 WESTSIDE RD, STATESBORO, GA 30458-6328
(912) 865-5223
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6795
GA
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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