Most Relevant Information
Provider Data
| NPI Number: | 1003220526 |
| Provider Name: | RICHARD ALLEN JETER DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 1223D0001X |
| Specialty: | Dentist |
| License Number: | 5355 |
Most Important Dates
| Enumeration Date: | 06/12/2014 |
| Last Updated: | 06/12/2014 |
Provider Practice Location
230 WARREN PL
CAMPBELLSVILLE
KY
427189618
Practice Location Phone/Fax
| Phone: | 2707892087 |
| Fax: |
Provider Mailing Location
230 WARREN PL
CAMPBELLSVILLE
KY
427189618
Provider Mailing Phone/Fax
| Phone: | 2707892087 |
| Fax: |