Individual
EVERETT JEWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1390 MONTREAL RD, TUCKER, GA 30084-8143
(770) 934-9700
Mailing address
1390 MONTREAL RD, TUCKER, GA 30084-8143
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12028
GA
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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