Organization
JEWELL FAMILY DENTAL
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
19135 GRAND RIVER AVE, DETROIT, MI 48223-1704
(313) 535-7770
Mailing address
19135 GRAND RIVER AVE, DETROIT, MI 48223-1704
(313) 535-7770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17336
MI
Other
Enumeration date
05/23/2007
Last updated
10/01/2007
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