Provider Demographics
NPI:1235847773
Name:THREE RIVERS JM DENTAL PC
Entity Type:Organization
Organization Name:THREE RIVERS JM DENTAL PC
Other - Org Name:KEEP MI SMILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:269-651-6700
Mailing Address - Street 1:17 VINEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-2375
Mailing Address - Country:US
Mailing Address - Phone:269-651-6700
Mailing Address - Fax:
Practice Address - Street 1:221 N HOOKER AVE
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-2231
Practice Address - Country:US
Practice Address - Phone:269-273-3065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental