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General NPI Number Information
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NPI Number | 1942368832
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Entity Type | Organization
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Legal Business Name | EBELING FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 3142 N ADRIAN HWY
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City | ADRIAN
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State | MI
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Zip | 49221
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Country | US
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Telephone | 517-263-6100
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Fax | 517-263-6110
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Provider Business Mailing Address
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Address Line | 3142 N ADRIAN HWY
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City | ADRIAN
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State | MI
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Zip | 49221
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Country | US
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Telephone | 517-263-6100
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Fax | 517-263-6110
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH D EBELING
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Credential | DDS
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Telephone | 517-263-6100
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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 | 2901017376
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License Number State | MI
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