Provider Demographics
NPI:1427865781
Name:PERRY L. JEFFRIES, DDS AND ASSOCIATES, PA
Entity type:Organization
Organization Name:PERRY L. JEFFRIES, DDS AND ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DDS
Authorized Official - Prefix:
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JEFFRIES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-230-0346
Mailing Address - Street 1:871 HUFFMAN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7205
Mailing Address - Country:US
Mailing Address - Phone:336-230-0346
Mailing Address - Fax:
Practice Address - Street 1:939 N. CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101
Practice Address - Country:US
Practice Address - Phone:336-230-0346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty