Individual
DR. JERRY A YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14 E SILVER ST, LEBANON, OH 45036-1804
(513) 932-2851
Mailing address
14 E SILVER ST, LEBANON, OH 45036-1804
(513) 932-2851
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30 013789
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30 013789
STATE LISENCE
OH
Enumeration date
05/31/2007
Last updated
07/08/2007
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