Individual
MR. JERRY LAMAR THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
128 MARTIN LUTHER KING JR CT, LAGRANGE, GA 30241-3656
(706) 884-8009
Mailing address
128 MARTIN LUTHER KING JR CT, LAGRANGE, GA 30241-3656
(706) 884-8009
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
1223D0001X
GA
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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