Provider Demographics
NPI:1275625337
Name:BECHTEL, JONATHAN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:J
Last Name:BECHTEL
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 1:609 E JOLLY RD
Mailing Address - Street 2:SUITE 10B
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910
Mailing Address - Country:US
Mailing Address - Phone:517-882-7132
Mailing Address - Fax:517-882-6608
Practice Address - Street 1:609 E JOLLY RD
Practice Address - Street 2:SUITE 10B
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910
Practice Address - Country:US
Practice Address - Phone:517-882-7132
Practice Address - Fax:517-882-6608
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI176321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice