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Individual

DR. TERRANCE L. JETER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1770 CANDLER RD, DECATUR, GA 30032-3277
(404) 688-1350
(404) 688-2962
Mailing address
1770 CANDLER RD, DECATUR, GA 30032-3277
(404) 289-2772
(404) 289-1139

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10799
GA
1223G0001X
General Practice Dentistry
DN10799
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9180930
GA
Enumeration date
02/01/2007
Last updated
01/19/2020
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