J Kenneth Weldon, Jr, DMD LLC
Organization Active NPI Endodontics · Clarkesville, GA
NPI 1275660904 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1275660904
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Endodontics 1223E0200X
- License
- 011386 (GA)
- Legal business name
- J KENNETH WELDON, JR, DMD LLC
- Practice address
- 172 Professional Park Dr
Clarkesville, GA 30523-5536 - Phone
- (706) 754-1015
- NPI assigned
- Feb 28, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. J. Kenneth Weldon Jr., DMD
- Title
- Owner
- Phone
- (706) 754-1015
Practitioners 1
-
Jerry Kenneth Weldon Jr., D.M.D.
National Provider Directory
Locations
172 Professional Park Dr
Clarkesville, GA 30523
Phone (706) 754-1015
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics |
1223E0200X | 011386 | GA | Yes |
Addresses
Primary practice location
172 Professional Park Dr
Clarkesville, GA 30523-5536
Mailing address
PO Box 1239
Clarkesville, GA 30523-0021
Phone (706) 754-1015
Other providers in Clarkesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.