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General NPI Number Information
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NPI Number | 1215817986
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Entity Type | Organization
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Legal Business Name | DR. LAWRENCE JELSCH
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 152 MAIN ST STE 7
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City | BELLEVILLE
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State | MI
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Zip | 48111-3911
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Country | US
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Telephone | 734-697-8597
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Fax | 734-697-4946
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Provider Business Mailing Address
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Address Line | 152 MAIN ST STE 7
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City | BELLEVILLE
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State | MI
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Zip | 48111-3911
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Country | US
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Telephone | 734-697-8597
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Fax | 734-697-4946
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Authorized Official
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Title or Position | DENTIST
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Name | MR. LAWRENCE MICHAEL JELSCH
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Credential | DDS
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Telephone | 734-697-8597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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