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Individual
JEREL NATHANIEL OWENS
Active
Individual
JEREL NATHANIEL OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901011444
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11293190
CAQH
MI
05
—
4718431
—
MI
01
—
88183
DELTA DENTAL
MI
Enumeration date
08/16/2006
Last updated
12/15/2022
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