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General NPI Number Information
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NPI Number | 1447479621
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Entity Type | Organization
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Legal Business Name | JAMES C. PEURACH DDS, P.C.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1510 N BROADWAY ST
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City | HASTINGS
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State | MI
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Zip | 49058-1007
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Country | US
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Telephone | 269-945-3358
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Fax | 269-945-3424
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Provider Business Mailing Address
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Address Line | 1510 N BROADWAY ST
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City | HASTINGS
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State | MI
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Zip | 49058-1007
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Country | US
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Telephone | 269-945-3358
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Fax | 269-945-3424
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES CARL PEURACH
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Credential | DDS
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Telephone | 269-945-3358
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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 | 014125
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License Number State | MI
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