Healthcare Provider Details

I. General information

NPI: 1841599230
Provider Name (Legal Business Name): JAMES R DONLEY DDS PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2011
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 N CAUSEWAY ST
N MUSKEGON MI
49445-3302
US

IV. Provider business mailing address

166 N CAUSEWAY ST
N MUSKEGON MI
49445-3302
US

V. Phone/Fax

Practice location:
  • Phone: 231-744-6661
  • Fax: 231-744-2837
Mailing address:
  • Phone: 231-744-6661
  • Fax: 231-744-2837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9163
License Number StateMI

VIII. Authorized Official

Name: DR. JAMES RUSSELL DONLEY
Title or Position: MANAGER/DENTIST
Credential: DDS
Phone: 231-744-6661