Individual
DR. DOUGLAS BRENT KERSEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
110 KIA DR, LAGRANGE, GA 30241-3731
(706) 242-2222
(706) 242-9220
Mailing address
110 KIA DR, LAGRANGE, GA 30241-3731
(706) 242-9222
(706) 242-9220
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013368
GA
1223G0001X
General Practice Dentistry
DN013368
GA
Other
Enumeration date
12/05/2006
Last updated
05/07/2019
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