Provider Demographics
NPI:1942604871
Name:JEFFREY L FLETCHER
Entity Type:Organization
Organization Name:JEFFREY L FLETCHER
Other - Org Name:FLETCHER DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CURD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-653-7455
Mailing Address - Street 1:219 N POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4005
Mailing Address - Country:US
Mailing Address - Phone:731-653-7455
Mailing Address - Fax:731-653-7457
Practice Address - Street 1:219 N POPLAR STREET
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-0219
Practice Address - Country:US
Practice Address - Phone:731-653-7455
Practice Address - Fax:731-653-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty