Individual
DR. JERROD LYNN SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5979 DESERT STORM AVE, FORT CAMPBELL, KY 42223-5514
(270) 412-8563
Mailing address
9900 LINCON ST FL 2, HQS USA DENTAC, JOINT BASE LEWIS MCCHORD, WA 98431-0001
(253) 968-4029
(253) 968-5919
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0021321
TX
1223P0700X
Prosthodontics
Primary
21321
TX
Other
Enumeration date
01/24/2006
Last updated
03/27/2023
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