Organization
PERRY L. JEFFRIES DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMELIA BURNETTE BA DAII (HUMAN RELATIONS/FIN COORDINATOR)
(336) 451-1957
Entity
Organization
Contact information
Practice address
1500 MOUNT ZION PL STE B, WINSTON SALEM, NC 27101-3254
(336) 748-0033
(336) 748-0414
Mailing address
1500 MOUNT ZION PL STE B, WINSTON SALEM, NC 27101-3254
(336) 748-0033
(336) 748-0414
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6832
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5907343
—
NC
Enumeration date
02/25/2009
Last updated
02/25/2009
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