Individual
DR. JACK HOBSON LEVERETT SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1515 MILULI AVE, BAINBRIDGE, GA 39819
(229) 246-1548
(229) 246-9936
Mailing address
1919 LAKE DOUGLAS ROAD, BAINBRIDGE, GA 39819
(229) 246-1718
(229) 246-9936
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
GA 6768
GA
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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