Provider Demographics
NPI:1558468074
Name:LESCH, JEAN HAZELFELDT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:HAZELFELDT
Last Name:LESCH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 SOUTH INDUSTRIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176
Mailing Address - Country:US
Mailing Address - Phone:734-429-9744
Mailing Address - Fax:734-429-1112
Practice Address - Street 1:160 SOUTH INDUSTRIAL DRIVE
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176
Practice Address - Country:US
Practice Address - Phone:734-429-9744
Practice Address - Fax:734-429-1112
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010157691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice