Jewell Lake Dental Llc | |
1889 W Trask Lake Rd Barton City MI 48705 | |
(989) 736-7000 | |
Not Available |
Full Name | Jewell Lake Dental Llc |
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Speciality | Dentist |
Location | 1889 W Trask Lake Rd, Barton City, Michigan |
Authorized Official Name and Position | Steven Rodriguez (OWNER) |
Authorized Official Contact | 9897367000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jewell Lake Dental Llc 1889 W Trask Lake Rd Po Box 193 Barton City MI 48705 Ph: (989) 736-7000 | Jewell Lake Dental Llc 1889 W Trask Lake Rd Barton City MI 48705 Ph: (989) 736-7000 |
NPI Number | 1114238151 |
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Provider Enumeration Date | 06/24/2010 |
Last Update Date | 06/24/2010 |
Identifier | Type | State | Issuer |
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1114238151 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 2901015703 (Michigan) | Primary |