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General NPI Number Information
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NPI Number | 1285455956
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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 | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 495 M 66
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City | ATHENS
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State | MI
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Zip | 49011-9613
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Country | US
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Telephone | 269-729-9430
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Fax | 269-659-8604
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Provider Business Mailing Address
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Address Line | PO BOX 156
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City | ATHENS
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State | MI
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Zip | 49011-0156
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Country | US
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Telephone | 269-729-9430
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Fax | 269-659-8604
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Authorized Official
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Title or Position | OWNER
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Name | JAMIE BARTMAN
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Credential | DMD
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Telephone | 269-651-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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