Individual
ANDREW JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4323 HILL ST, COLUMBIA, SC 29207-6022
(803) 751-6209
Mailing address
4323 HILL ST, COLUMBIA, SC 29207-6022
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12815360-9922
UT
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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