Provider Demographics
NPI:1982865093
Name:JAMERA DDS PC & ASSOCIATES
Entity Type:Organization
Organization Name:JAMERA DDS PC & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-379-9375
Mailing Address - Street 1:4321 JAMES MADISON HWY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FORK UNION
Mailing Address - State:VA
Mailing Address - Zip Code:23055-2025
Mailing Address - Country:US
Mailing Address - Phone:434-842-3504
Mailing Address - Fax:434-842-3534
Practice Address - Street 1:4321 JAMES MADISON HWY
Practice Address - Street 2:SUITE 6
Practice Address - City:FORK UNION
Practice Address - State:VA
Practice Address - Zip Code:23055-2025
Practice Address - Country:US
Practice Address - Phone:434-842-3504
Practice Address - Fax:434-842-3534
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMERA DDS PC & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA401006912122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty