Organization
VISITING DENTAL ASSOCIATES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINALD BERNARD JEWELL DDS (PRESIDENT)
(313) 535-7770
Entity
Organization
Contact information
Practice address
20770 KELLY RD, SUITE B, EASTPOINTE, MI 48021-3114
(586) 779-3333
Mailing address
20770 KELLY RD, SUITE B, EASTPOINTE, MI 48021-3114
(586) 779-3333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17336
MI
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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