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Contact Information

JEWELL LAKE DENTAL LLC
1889 W TRASK LAKE RD
BARTON CITY, MI48705
 Phone: 989-736-7000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JEWELL LAKE DENTAL LLC

NPI # 1114238151
LBN Legal business name JEWELL LAKE DENTAL LLC
Authorized official STEVEN RODRIGUEZ - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/24/2010
Last updated 06/24/2010 - About 16 years ago
Identifiers
MI License # 2901015703
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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