Provider Demographics
NPI:1053459222
Name:JAMES P VANLANDSCHOOT
Entity Type:Organization
Organization Name:JAMES P VANLANDSCHOOT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:VANLANDSCHOOT
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:906-228-4646
Mailing Address - Street 1:760 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4138
Mailing Address - Country:US
Mailing Address - Phone:906-228-4646
Mailing Address - Fax:906-228-4166
Practice Address - Street 1:760 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4138
Practice Address - Country:US
Practice Address - Phone:906-228-4646
Practice Address - Fax:906-228-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI012440122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty