Provider Demographics
NPI:1285455956
Name:JM DENTAL GROUP PC
Entity type:Organization
Organization Name:JM DENTAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:269-651-6700
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:MI
Mailing Address - Zip Code:49011-0156
Mailing Address - Country:US
Mailing Address - Phone:269-729-9430
Mailing Address - Fax:269-659-8604
Practice Address - Street 1:495 M 66
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:MI
Practice Address - Zip Code:49011-9613
Practice Address - Country:US
Practice Address - Phone:269-729-9430
Practice Address - Fax:269-659-8604
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JM DENTAL GROUP, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty