Healthcare Provider Details

I. General information

NPI: 1215965512
Provider Name (Legal Business Name): JOHN THOMAS DAY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 E SAGINAW ST
LANSING MI
48912-2326
US

IV. Provider business mailing address

1801 E SAGINAW ST
LANSING MI
48912-2326
US

V. Phone/Fax

Practice location:
  • Phone: 517-484-3310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901014838
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: