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Individual

DR. JEFFREY L FLETCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
715 MORTON ST, PARIS, TN 38242-4210
(731) 642-3059
Mailing address
715 MORTON ST, PARIS, TN 38242-4210
(731) 642-3059

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8547
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4130884
BLUE CROSS BLUE SHIELD
TN
01
9184071
TENNCARE PROVIDER NUMBER
TN
Enumeration date
10/25/2006
Last updated
07/08/2007
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