Individual
DR. SAMANTHA M JEFFERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
5222 US-51 N, MERCER, WI 54548
(715) 476-3432
Mailing address
5738 W BELMONT AVE, CHICAGO, IL 60634-5208
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1002012-15
WI
1223G0001X
General Practice Dentistry
Primary
319.019980
IL
Other
Enumeration date
06/08/2016
Last updated
10/08/2020
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