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Individual

SIMUEL LAZAAR JAMISON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
DEPT OF THE ARMY, DENTAL ACTIVITY, STOP B, 2817 REILLY RD, MCDS-NA-B, FORT BRAGG, NC 28310-0001
(910) 396-5610
(910) 396-7017
Mailing address
DEPT OF THE ARMY, DENTAL ACTIVITY, STOP B, 2817 REILLY RD, MCDS-NA-B, FORT BRAGG, NC 28310-0001
(910) 396-5610
(910) 396-7017

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
7435
KY

Other

Enumeration date
12/21/2005
Last updated
03/07/2023
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