| Jewell Lake Dental Llc | |
|
1889 W Trask Lake Rd Barton City MI 48705 | |
| (989) 736-7000 | |
| Not Available |
| Full Name | Jewell Lake Dental Llc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 06/24/2010 |
| Last Update Date | 06/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114238151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901015703 (Michigan) | Primary |
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