Individual
AUSTIN JEFFREY SECRIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
115 GORDON ST, THOMSON, GA 30824-1537
(760) 221-5892
Mailing address
2004 TURNER DR, EVANS, GA 30809-6704
(760) 221-5892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122717
GA
Other
Enumeration date
06/25/2022
Last updated
06/25/2022
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