Provider Demographics
NPI:1699099853
Name:STERETT, ERIC J (DMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:STERETT
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 1:2437 LUMPKIN RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-3000
Mailing Address - Country:US
Mailing Address - Phone:706-796-6269
Mailing Address - Fax:706-796-6386
Practice Address - Street 1:2437 LUMPKIN RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-3000
Practice Address - Country:US
Practice Address - Phone:706-796-6269
Practice Address - Fax:706-796-6386
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist