Provider Demographics
NPI:1689335242
Name:JBJ DDS, PLLC
Entity Type:Organization
Organization Name:JBJ DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:BAYMA-JILEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:269-695-3601
Mailing Address - Street 1:121 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:MI
Mailing Address - Zip Code:49107-1410
Mailing Address - Country:US
Mailing Address - Phone:269-695-3601
Mailing Address - Fax:269-695-3694
Practice Address - Street 1:121 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:MI
Practice Address - Zip Code:49107-1410
Practice Address - Country:US
Practice Address - Phone:269-695-3601
Practice Address - Fax:269-695-3694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental