Organization
RONALD D JESSUP DMD PC
Active
Other names
Gentle Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD D JESSUP DMD (OWNER)
(276) 628-8164
Entity
Organization
Contact information
Practice address
14245 LEE HWY, BRISTOL, VA 24202-4317
(276) 628-8164
(276) 644-3145
Mailing address
14245 LEE HWY, BRISTOL, VA 24202-4317
(276) 628-8164
(276) 644-3145
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223G0001X
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164996
—
VA
Enumeration date
03/28/2006
Last updated
07/10/2013
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