MEDICARE: JAMES R. DONLEY DDS

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
1	1223G0001X	General Practice Dentistry	9163	MI

General Provider Information

NPI Number	:	1528012697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES R. DONLEY DDS

Provider Business Mailing Address
First Line	:	166 N CAUSEWAY ST
Second Line	:
City	:	N MUSKEGON
State	:	MI
Zip	:	49445-3302
Country	:	US
Telephone Number	:	231-744-6661
Fax Number	:	231-744-2837

Provider Business Practice Location Address
First Line	:	166 N CAUSEWAY ST
Second Line	:
City	:	N MUSKEGON
State	:	MI
Zip	:	49445-3302
Country	:	US
Telephone Number	:	231-744-6661
Fax Number	:	231-744-2837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2006
Last Update Date	:	04/11/2011

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