Individual
DR. JERRY DELL BENNETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
305 UNIVERSITY DR, SUITE 3, VALDOSTA, GA 31602-2626
(229) 671-1900
(229) 671-1999
Mailing address
305 UNIVERSITY DR, SUITE 3, VALDOSTA, GA 31602-2626
(229) 671-1900
(229) 671-1999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11534
GA
1223G0001X
General Practice Dentistry
Primary
11534
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100967
AVESIS
GA
01
—
1427670
UNITED CONCORDIA
GA
01
—
9813258
DORAL
GA
Enumeration date
12/19/2006
Last updated
09/11/2025
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