Individual
DR. JEFFREY BENNETT JETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
230 CARROLL ST STE 3, SHREVEPORT, LA 71105-4248
(318) 869-2593
(318) 869-2592
Mailing address
461 HARRIS LN, SHREVEPORT, LA 71106-8305
(318) 797-3924
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LA3101
LA
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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