Provider Demographics
NPI:1003851643
Name:ESHELMAN, JERE B (DDS)
Entity Type:Individual
Prefix:DR
First Name:JERE
Middle Name:B
Last Name:ESHELMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 WOODCREST AVE
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-2516
Mailing Address - Country:US
Mailing Address - Phone:717-626-1400
Mailing Address - Fax:
Practice Address - Street 1:410 WOODCREST AVE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-2516
Practice Address - Country:US
Practice Address - Phone:717-626-1400
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019241L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist