Individual
DR. JERRY GUWAYNE EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1403 JOHNSON ST, TALLULAH, LA 71282-5513
(318) 574-0765
(318) 493-5085
Mailing address
1403 JOHNSON ST, TALLULAH, LA 71282-5513
(318) 574-0765
(318) 493-5085
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4479
LA
Other
Enumeration date
11/22/2006
Last updated
09/21/2022
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