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Individual

DR. JIMMIE DWIGHT LASSITER JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
5285 COMMERCE ST, JAY, FL 32565-1179
(850) 675-8545
(850) 675-1950
Mailing address
3200 COBBTOWN RD, JAY, FL 32565-9206
(850) 675-6715

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN0014325
FL

Other

Enumeration date
06/05/2006
Last updated
07/08/2007
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