Individual
CAROL L JEFFRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6300 GRAND AVE, GURNEE, IL 60031-4538
(224) 214-4902
Mailing address
1125 MUSEUM BLVD UNIT 307, VERNON HILLS, IL 60061-3194
(703) 470-3791
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032074
IL
122300000X
Dentist
105209
CA
Other
Enumeration date
06/20/2019
Last updated
08/06/2020
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