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General NPI Number Information
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NPI Number | 1730299835
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Entity Type | Organization
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Legal Business Name | DRS PEARSON JEFFERSON AND CAMP PA
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/15/2007
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Provider Practice Location Address
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Address Line | 8301 BANDFORD WAY SUITE 121
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City | RALEIGH
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State | NC
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Zip | 27615-2767
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Country | US
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Telephone | 919-876-4746
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Fax | 919-876-5071
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Provider Business Mailing Address
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Address Line | 8301 BANDFORD WAY SUITE 121
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City | RALEIGH
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State | NC
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Zip | 27615-2767
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Country | US
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Telephone | 919-876-4746
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Fax | 919-876-5071
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Authorized Official
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Title or Position | TREASURER
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Name | DR. JAY A JEFFERSON
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Credential | DDS
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Telephone | 919-876-4746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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