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General NPI Number Information
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NPI Number | 1659678803
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Entity Type | Organization
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Legal Business Name | ANDREW RUMMEL, PLLC
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 300 N LAKE ST
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City | CADILLAC
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State | MI
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Zip | 49601-1846
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Country | US
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Telephone | 231-775-6597
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Fax |
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Provider Business Mailing Address
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Address Line | 300 N LAKE ST
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City | CADILLAC
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State | MI
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Zip | 49601-1846
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | ANDREW RUMMEL
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Credential |
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Telephone | 231-775-6597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2901019920
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License Number State | MI
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