# JEWELL FAMILY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932319746
- **Authorized official:** DR. REGINALD BERNARD JEWELL DDS (PRESIDENT)
- **Authorized official phone:** (313) 535-7770

## Contact information

- **Practice address:** 19135 GRAND RIVER AVE, DETROIT, MI 48223-1704
- **Practice address phone:** (313) 535-7770
- **Mailing address:** 19135 GRAND RIVER AVE, DETROIT, MI 48223-1704
- **Mailing address phone:** (313) 535-7770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 17336 | MI | Yes |

## Other

- **Enumeration date:** 05/23/2007
- **Last updated:** 10/01/2007