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Individual

DR. HAROLD STEWART JETER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
804 4TH ST E, SOUTH POINT, OH 45680-9117
(740) 377-2020
(740) 377-4961
Mailing address
804 4TH ST E, P.O. BOX 517, SOUTH POINT, OH 45680-9117
(740) 377-2020
(740) 377-4961

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8417
KY
1223G0001X
General Practice Dentistry
Primary
30-02-0354
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3053270
OH
05
7100118710
KY
Enumeration date
08/24/2005
Last updated
06/07/2017
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