# JEREL OWENS D.M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JEREL N OWENS D.M.D., P. C.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1760633747
- **Legal business name:** JEREL N OWENS D.M.D., P. C.
- **Authorized official:** MR. JEREL OWENS D.M.D., P.C. (PRESIDENT)
- **Authorized official phone:** (313) 273-0640

## Contact information

- **Practice address:** 15344 W. MCNICHOLS, DETROIT, MI 48235-3722
- **Practice address phone:** (313) 273-0640
- **Practice address fax:** (313) 273-0118
- **Mailing address:** 15344 W MCNICHOLS RD, DETROIT, MI 48235-3722
- **Mailing address phone:** (313) 273-0640
- **Mailing address fax:** (313) 273-0118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 11444 | MI | Yes |

## Other

- **Enumeration date:** 10/08/2008
- **Last updated:** 10/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4057226 | — | MI |