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General NPI Number Information
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NPI Number | 1831603976
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Entity Type | Organization
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Legal Business Name | KANE DENTISTRY
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 760 W EISENHOWER PKWY STE 120
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City | ANN ARBOR
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State | MI
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Zip | 48103-5890
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Country | US
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Telephone | 734-995-4699
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Fax |
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Provider Business Mailing Address
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Address Line | 760 W EISENHOWER PKWY STE 120
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City | ANN ARBOR
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State | MI
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Zip | 48103-5890
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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 | OWNER DENTIST
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Name | DR. JESSE S KANE
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Credential | DDS MS PLLC
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Telephone | 734-274-0667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State | MI
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