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1710009147
BEN WALL JERNIGAN
DECATUR, GA
NPI
1710009147
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: GA GA8612)
Enumeration Date
2007-04-05
Last Update Date
2007-07-08
Business Address
Dr. BEN WALL JERNIGAN DMD
315 W PONCE DE LEON AVE SUITE 340
DECATUR, GA 30030-2400
Phone number: 404-378-1466
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Mailing Address
Dr. BEN WALL JERNIGAN DMD
315 W PONCE DE LEON AVE SUITE 340
DECATUR, GA 30030-2400
Phone number: 404-378-1466
Copy
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