Provider Demographics
NPI:1932265949
Name:JARMAN, ROY G JR (DDS ORAL MAXILLOFACI)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:G
Last Name:JARMAN
Suffix:JR
Gender:M
Credentials:DDS ORAL MAXILLOFACI
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Mailing Address - Street 1:211 SOUTH CRAPO STREET
Mailing Address - Street 2:SUITE K
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858
Mailing Address - Country:US
Mailing Address - Phone:989-772-9402
Mailing Address - Fax:989-772-7630
Practice Address - Street 1:211 SOUTH CRAPO STREET
Practice Address - Street 2:SUITE K
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858
Practice Address - Country:US
Practice Address - Phone:989-772-9402
Practice Address - Fax:989-772-7630
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI29010110681223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MISID1106800OtherBLUE CROSS DENTAL
MI4050280Medicaid
T82850Medicare UPIN
MI4050280Medicaid