Individual
JONATHAN LANE PUTNAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
150 FAIRVIEW RD, SUITE 135, MOORESVILLE, NC 28117-9500
(704) 799-3247
(866) 623-7002
Mailing address
150 FAIRVIEW RD, SUITE 135, MOORESVILLE, NC 28117-9500
(704) 799-3247
(866) 623-7002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6713
NC
Other
Enumeration date
06/09/2006
Last updated
07/08/2007
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