Provider Demographics
NPI:1336745975
Name:JAMIESON ORTHODONTICS
Entity type:Organization
Organization Name:JAMIESON ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMIESON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:906-228-8720
Mailing Address - Street 1:1029 LINCOLN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2680
Mailing Address - Country:US
Mailing Address - Phone:906-228-8720
Mailing Address - Fax:906-228-2064
Practice Address - Street 1:1029 LINCOLN AVE STE 1
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2680
Practice Address - Country:US
Practice Address - Phone:906-228-8720
Practice Address - Fax:906-228-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty