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General NPI Number Information
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NPI Number | 1942811542
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Entity Type | Organization
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Legal Business Name | COLDWATER JM DENTAL PC
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 72 W CHICAGO ST
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City | COLDWATER
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State | MI
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Zip | 49036-1606
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Country | US
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Telephone | 517-278-2744
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Fax |
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Provider Business Mailing Address
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Address Line | 17 VINEWOOD AVE
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City | STURGIS
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State | MI
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Zip | 49091-2375
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Country | US
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Telephone | 517-278-2744
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMIE BARTMAN
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Credential | DDS
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Telephone | 517-278-2744
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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