Provider Demographics
NPI:1699981795
Name:JARVIE, STEPHEN JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JAMES
Last Name:JARVIE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23595 NOVI RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5441
Mailing Address - Country:US
Mailing Address - Phone:248-449-8000
Mailing Address - Fax:
Practice Address - Street 1:23595 NOVI RD
Practice Address - Street 2:SUITE 110
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5441
Practice Address - Country:US
Practice Address - Phone:248-449-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010161431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice