| Jackson Center For Cosmetic And Restorative Dentistry | |
|
2641 Shirley Dr Jackson MI 49201-8633 | |
| (517) 787-5367 | |
| (517) 787-4219 |
| Full Name | Jackson Center For Cosmetic And Restorative Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2641 Shirley Dr, Jackson, Michigan |
| Authorized Official Name and Position | Daryl William Frederick (OWNER) |
| Authorized Official Contact | 5177875367 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Center For Cosmetic And Restorative Dentistry 2641 Shirley Dr Jackson MI 49201-8633 Ph: (517) 787-5367 | Jackson Center For Cosmetic And Restorative Dentistry 2641 Shirley Dr Jackson MI 49201-8633 Ph: (517) 787-5367 |
| NPI Number | 1942354725 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942354725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10125 (Michigan) | Primary |
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Richard L. Carpenter, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2532 Spring Arbor Rd, Unit 4, Jackson, MI 49203 Phone: 517-789-8622 Fax: 517-789-8636 | |
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