Organization
THE CENTER FOR FUNCTIONAL & AESTHETIC FACIAL SURGERY
Active
Other names
Jeffrey S. Jelic, DMD, MD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER THOMAS PICKETT (PATIENT CARE COORDINATOR)
(919) 419-9222
Entity
Organization
Contact information
Practice address
5501 FORTUNES RIDGE DR, SUITE G, DURHAM, NC 27713-6102
(919) 419-9222
(919) 419-9255
Mailing address
5501 FORTUNES RIDGE DR, SUITE G, DURHAM, NC 27713-6102
(919) 419-9222
(919) 419-9255
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9900887
NC
Other
Enumeration date
11/29/2006
Last updated
08/22/2020
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