Individual
DR. NATHAN JANDERNOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2410 LAKE LANSING RD STE 2, LANSING, MI 48912-3659
(517) 371-5342
(517) 371-5320
Mailing address
2410 LAKE LANSING RD STE 2, LANSING, MI 48912-3659
(517) 371-5342
(517) 371-5320
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
290102264
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
365155275
—
MI
Enumeration date
06/06/2018
Last updated
06/06/2018
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