Healthcare Provider Details

I. General information

NPI: 1528012697
Provider Name (Legal Business Name): JAMES R. DONLEY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2006
Last Update Date: 04/11/2011
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 Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9163
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: