Organization
JEREL N OWENS, DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREL NATHANIEL OWENS D.M.D. (PRESIDENT)
(313) 273-0640
Entity
Organization
Contact information
Practice address
15344 W MCNICHOLS RD, DETROIT, MI 48235-3722
(313) 273-0640
(313) 273-0118
Mailing address
15344 W MCNICHOLS RD, DETROIT, MI 48235-3722
(313) 273-0640
(313) 273-0118
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2901011444
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760633747
—
MI
Enumeration date
04/17/2015
Last updated
04/17/2015
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