Individual
DR. JERRY GARDNER MCKINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
110 FRANKLIN AVE N, FAYETTEVILLE, TN 37334-3012
(931) 433-4265
Mailing address
110 FRANKLIN AVE N, FAYETTEVILLE, TN 37334-3012
(931) 433-4265
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4381
TN
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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