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General NPI Number Information
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NPI Number | 1346407152
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Entity Type | Organization
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Legal Business Name | JAMES S GEISTER, DDS, PC
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 66611 VAN DYKE RD
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City | WASHINGTON
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State | MI
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Zip | 48095-2021
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Country | US
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Telephone | 586-752-4545
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Fax | 586-752-5369
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Provider Business Mailing Address
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Address Line | 66611 VAN DYKE RD
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City | WASHINGTON
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State | MI
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Zip | 48095-2021
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Country | US
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Telephone | 586-752-4545
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Fax | 586-752-5369
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES S GEISTER
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Credential | DENTIST
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Telephone | 586-752-4545
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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 | 2901011199
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License Number State | MI
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