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General NPI Number Information
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NPI Number | 1265694459
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Entity Type | Organization
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Legal Business Name | JONATHAN J. BECHTEL D.D.S., P.C.
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Dates
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Enumeration Date | 06/28/2008
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Last Update Date | 06/28/2008
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Provider Practice Location Address
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Address Line | 609 E JOLLY RD SUITE 10B
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City | LANSING
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State | MI
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Zip | 48910-6801
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Country | US
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Telephone | 517-882-7132
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Fax |
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Provider Business Mailing Address
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Address Line | 609 E JOLLY RD SUITE 10B
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City | LANSING
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State | MI
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Zip | 48910-6801
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Country | US
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Telephone | 517-882-7132
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN JASON BECHTEL
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Credential | D.D.S.
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Telephone | 517-882-7132
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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 | 17632
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License Number State | MI
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