Organization
DENTISTRY BY DESIGN OF JACKSON, PLC
Active
Parent organization
DENTISTRY BY DESIGN OF JACKSON, PLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTISTRY BY DESIGN OF JACKSON, PLC
Authorized official
DR. ANDREW JAMES BALAZE D.M.D. (DENTIST/OWNER)
(517) 787-5055
Entity
Organization
Contact information
Practice address
306 W WASHINGTON AVE STE 205, JACKSON, MI 49201-2141
(517) 787-5055
(517) 787-9346
Mailing address
306 W WASHINGTON AVE STE 205, JACKSON, MI 49201-2141
(517) 787-5055
(517) 787-9346
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901020967
MI
332B00000X
Durable Medical Equipment & Medical Supplies
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Other
Enumeration date
03/22/2017
Last updated
08/07/2019
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