Provider Demographics
NPI:1619032729
Name:STEWART, JAMES ROSS JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROSS
Last Name:STEWART
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:15873 MIDDLEBELT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3811
Mailing Address - Country:US
Mailing Address - Phone:734-425-4400
Mailing Address - Fax:734-425-8067
Practice Address - Street 1:15873 MIDDLEBELT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3811
Practice Address - Country:US
Practice Address - Phone:734-425-4400
Practice Address - Fax:734-425-8067
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI147501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice