Individual
JEFFERY KIRK MACHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1295 CHURCH ST, ZACHARY, LA 70791-2347
(225) 654-1490
(225) 654-2023
Mailing address
1295 CHURCH ST, ZACHARY, LA 70791-2347
(225) 654-1490
(225) 654-2023
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3983
LA
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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