Provider Demographics
NPI:1942324553
Name:JURAND, JERRY GEORGE (DMD,DDS)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:GEORGE
Last Name:JURAND
Suffix:
Gender:M
Credentials:DMD,DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BERKELEY SQ
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2416
Mailing Address - Country:US
Mailing Address - Phone:901-685-2112
Mailing Address - Fax:901-685-2112
Practice Address - Street 1:7 S HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-4609
Practice Address - Country:US
Practice Address - Phone:901-685-2112
Practice Address - Fax:901-685-2112
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000017191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice