Provider Demographics
NPI:1043349848
Name:DR JEFFREY ALLEN DULUDE DDS PLC
Entity Type:Organization
Organization Name:DR JEFFREY ALLEN DULUDE DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:DULUDE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-835-7842
Mailing Address - Street 1:314 NORTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-7348
Mailing Address - Country:US
Mailing Address - Phone:989-835-7842
Mailing Address - Fax:989-835-4804
Practice Address - Street 1:314 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-7348
Practice Address - Country:US
Practice Address - Phone:989-835-7842
Practice Address - Fax:989-835-4804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010143971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty