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NPI Code Detail

MEDICARE: DR. NATHAN SHANE POUND D.D.S.

MEDICARE: DR. NATHAN SHANE POUND D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist2901019773MI

General Provider Information

NPI Number : 1205094323
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN SHANE POUND D.D.S.
Provider Business Mailing Address
First Line : 2885 SPRING ARBOR RD
Second Line :
City : JACKSON
State : MI
Zip : 49203-3607
Country : US
Telephone Number : 517-787-0900
Fax Number :
Provider Business Practice Location Address
First Line : 2885 SPRING ARBOR RD
Second Line :
City : JACKSON
State : MI
Zip : 49203-3607
Country : US
Telephone Number : 517-787-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2008
Last Update Date : 07/21/2008

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Directions to “ DR. NATHAN SHANE POUND D.D.S.” Practice Location

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