Provider Demographics
NPI:1346401874
Name:YEZERSKI, JOHN ERIC (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ERIC
Last Name:YEZERSKI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 NEW HIGHWAY 96 W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2556
Mailing Address - Country:US
Mailing Address - Phone:615-591-8880
Mailing Address - Fax:615-591-8827
Practice Address - Street 1:509 NEW HIGHWAY 96 W
Practice Address - Street 2:SUITE 100
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2556
Practice Address - Country:US
Practice Address - Phone:615-591-8880
Practice Address - Fax:615-591-8827
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8826122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist