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General NPI Number Information
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NPI Number | 1740388958
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Entity Type | Individual
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Provider Name | JEFFREY JEROME CALDWELL SR. D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 405 S MCCASKEY RD STE C
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City | WILLIAMSTON
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State | NC
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Zip | 27892-2160
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Country | US
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Telephone | 252-792-1101
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Fax | 252-792-1102
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Provider Business Mailing Address
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Address Line | 405 S MCCASKEY RD STE C P. O. BOX 621
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City | WILLIAMSTON
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State | NC
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Zip | 27892-2160
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Country | US
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Telephone | 252-792-1101
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Fax | 252-792-1102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5898
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License Number State | NC
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