Provider Demographics
NPI:1336298678
Name:JAMES L. SOUERS, D.D.S., ORTHODONTIST, P.C.
Entity Type:Organization
Organization Name:JAMES L. SOUERS, D.D.S., ORTHODONTIST, P.C.
Other - Org Name:MICHIGAN ORTHODONTIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:SOUERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,PC
Authorized Official - Phone:269-544-1222
Mailing Address - Street 1:950 N 10TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-6112
Mailing Address - Country:US
Mailing Address - Phone:269-544-1222
Mailing Address - Fax:269-544-1221
Practice Address - Street 1:950 N 10TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-6112
Practice Address - Country:US
Practice Address - Phone:269-544-1222
Practice Address - Fax:269-544-1221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010100331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty