Individual
DR. JERRY LEE GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2501 MAPLE ST, ABILENE, TX 79602-5058
(325) 795-3298
(325) 795-3203
Mailing address
2533 MEADOW LAKE DR, ABILENE, TX 79606-4317
(325) 698-8595
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
9787
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84C113
BCBS PROVIDER #
TX
Enumeration date
08/07/2006
Last updated
07/08/2007
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