| Jeffersonville Family Dental, Pc | |
|
900 Spring St Suite B Jeffersonville IN 47130-3675 | |
| (812) 288-8131 | |
| (812) 280-7184 |
| Full Name | Jeffersonville Family Dental, Pc |
|---|---|
| Speciality | Dentist |
| Location | 900 Spring St, Jeffersonville, Indiana |
| Authorized Official Name and Position | James Edward Terrell Smith (PRESIDENT) |
| Authorized Official Contact | 8122888131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffersonville Family Dental, Pc 900 Spring St Suite B Jeffersonville IN 47130-3675 Ph: (812) 288-8131 | Jeffersonville Family Dental, Pc 900 Spring St Suite B Jeffersonville IN 47130-3675 Ph: (812) 288-8131 |
| NPI Number | 1144696600 |
|---|---|
| Provider Enumeration Date | 08/19/2015 |
| Last Update Date | 08/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144696600 | NPI | - | NPPES |
| 200911820 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12011200A (Indiana) | Primary |
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