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Organization

JEREL OWENS D.M.D., P.C.

Active
Parent organization
JEREL N OWENS D.M.D., P. C.
Organization subpart
Yes

Provider details

NPI number
Legal business name
JEREL N OWENS D.M.D., P. C.
Authorized official
MR. JEREL OWENS D.M.D., P.C. (PRESIDENT)
(313) 273-0640
Entity
Organization

Contact information

Practice address
15344 W. MCNICHOLS, 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
1223G0001X
General Practice Dentistry
Primary
11444
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4057226
MI
Enumeration date
10/08/2008
Last updated
10/08/2008
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