| Organization Name: | JEBEDIAH S CHRISTY DDS - POOLER PLLC |
| NPI Number: | 1043617293 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEBEDIAH S CHRISTY (DDS/OWNER) |
| Mailing Address: | 276 Pooler Pkwy Ste A Pooler |
| State: | GA US |
| Postal Code: | 313225163 |
| Phone Number: | 9123309070 |
| Fax Number: | |
| NPI Enumeration Date: | 12/03/2014 |
| NPI Last Update Date: | 12/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |