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1710111034
JERRY DEANE TANKERSLEY
CLARKSDALE, MS
NPI
1710111034
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: MS 2300-86)
Enumeration Date
2009-05-14
Last Update Date
2009-06-30
Business Address
JERRY DEANE TANKERSLEY D.M.D.
800 OHIO AVE
CLARKSDALE, MS 38614-7200
Phone number: 662-624-4292
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Mailing Address
JERRY DEANE TANKERSLEY D.M.D.
510 HIGHWAY 322
CLARKSDALE, MS 38614-4717
Phone number: 662-624-2504
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