IndividualActive
Jerry Thomas
NPI 1326170663 · Public Health Dentistry · Lagrange, GA
Provider details
- NPI number
- 1326170663
- Entity type
- Individual
- Primary specialty
- Public Health DentistryDental Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 1223D0001X (GA)
Specialties & taxonomies
Dental Providers
Practice location
128 Martin Luther King Jr Ct
Lagrange, GA 30241-3656
Phone: (706) 884-8009
Approximate (ZIP-level) locationGet directions
Mailing address
128 Martin Luther King Jr Ct
Lagrange, GA 30241-3656
Registry dates
- Enumerated
- 2007-03-12
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.