Individual
JEFFREY JELIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
508 FULTON ST, DURHAM, NC 27705-3875
(909) 286-6960
Mailing address
508 FULTON ST, DURHAM, NC 27705-3875
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
9900887
NC
Other
Enumeration date
06/25/2006
Last updated
07/08/2007
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