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General NPI Number Information
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NPI Number | 1245248962
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Entity Type | Individual
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Provider Name | JOHN JAMNIK D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 2711 ORCHARD LAKE RD
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City | KEEGO HARBOR
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State | MI
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Zip | 48320-1446
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Country | US
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Telephone | 248-682-0922
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Fax |
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Provider Business Mailing Address
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Address Line | 5285 IROQUOIS CT
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City | CLARKSTON
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State | MI
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Zip | 48348-3013
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Country | US
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Telephone | 248-394-1853
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13582
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License Number State | MI
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