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General NPI Number Information
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NPI Number | 1285436113
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Entity Type | Organization
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Legal Business Name | JM DENTAL GROUP PC
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 435 E MAIN ST
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City | MENDON
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State | MI
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Zip | 49072-8744
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Country | US
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Telephone | 269-496-8484
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Fax | 269-659-8604
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Provider Business Mailing Address
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Address Line | 17 VINEWOOD AVE
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City | STURGIS
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State | MI
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Zip | 49091-2375
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Country | US
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Telephone | 269-651-6700
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Fax | 269-659-8604
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Authorized Official
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Title or Position | BILLING /INSURANCE/ CREDENTIALING
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Name | PATSY A PLIKERD
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Credential |
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Telephone | 269-216-9298
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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 |
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License Number State |
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