Individual
JEFFERY DAVID RENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7765 S COUNTY ROAD 231, RECEPTION / MEDICAL CENTER, LAKE BUTLER, FL 32054-5721
(386) 496-6171
(396) 486-6545
Mailing address
PO BOX 628, RECEPTION / MEDICAL CENTER, LAKE BUTLER, FL 32054-0628
(386) 496-6171
(386) 496-6545
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D3387
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DTC 147
FL
Other
Enumeration date
01/30/2006
Last updated
09/09/2009
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