Healthcare Provider Details

I. General information

NPI: 1548386816
Provider Name (Legal Business Name): JEFFREY LLOYD ESCOTE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30690 BECK RD
NOVI MI
48377-1036
US

IV. Provider business mailing address

30690 BECK RD
NOVI MI
48377-1036
US

V. Phone/Fax

Practice location:
  • Phone: 248-669-3600
  • Fax: 248-669-0867
Mailing address:
  • Phone: 248-669-3600
  • Fax: 248-669-0867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901015966
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: