MEDICARE: JAMES A JERMAN DDS PLLC

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	261QS0112X	Oral and Maxillofacial Surgery Clinic/Center	2442	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811395882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES A JERMAN DDS PLLC

Provider Business Mailing Address
First Line	:	22 2ND AVE W
Second Line	:	SUITE 1000
City	:	KALISPELL
State	:	MT
Zip	:	59901-4466
Country	:	US
Telephone Number	:	406-752-4375
Fax Number	:	406-756-6471

Provider Business Practice Location Address
First Line	:	22 2ND AVE W
Second Line	:	SUITE 1000
City	:	KALISPELL
State	:	MT
Zip	:	59901-4466
Country	:	US
Telephone Number	:	406-752-4375
Fax Number	:	406-756-6471

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. JAMES JERMAN
Credential	:	DDS
Telephone Number	:	406-752-4375

Provider Enumeration Date	:	12/08/2014
Last Update Date	:	09/19/2016

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