Provider Demographics
NPI:1215817986
Name:DR. LAWRENCE JELSCH
Entity type:Organization
Organization Name:DR. LAWRENCE JELSCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JELSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-697-8597
Mailing Address - Street 1:152 MAIN ST STE 7
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-3911
Mailing Address - Country:US
Mailing Address - Phone:734-697-8597
Mailing Address - Fax:734-697-4946
Practice Address - Street 1:152 MAIN ST STE 7
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-3911
Practice Address - Country:US
Practice Address - Phone:734-697-8597
Practice Address - Fax:734-697-4946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental