| Jerel Owens D.m.d., P.c. | |
|
15344 W. Mcnichols Detroit MI 48235-3722 | |
| (313) 273-0640 | |
| (313) 273-0118 |
| Full Name | Jerel Owens D.m.d., P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15344 W. Mcnichols, Detroit, Michigan |
| Authorized Official Name and Position | Jerel Owens (PRESIDENT) |
| Authorized Official Contact | 3132730640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerel Owens D.m.d., P.c. 15344 W Mcnichols Rd Detroit MI 48235-3722 Ph: (313) 273-0640 | Jerel Owens D.m.d., P.c. 15344 W. Mcnichols Detroit MI 48235-3722 Ph: (313) 273-0640 |
| NPI Number | 1760633747 |
|---|---|
| Provider Enumeration Date | 10/08/2008 |
| Last Update Date | 10/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760633747 | NPI | - | NPPES |
| 4057226 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 11444 (Michigan) | Primary |
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