Provider Demographics
NPI:1841599230
Name:JAMES R DONLEY DDS PLC
Entity Type:Organization
Organization Name:JAMES R DONLEY DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:DONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-744-6661
Mailing Address - Street 1:166 N CAUSEWAY ST
Mailing Address - Street 2:
Mailing Address - City:N MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-3302
Mailing Address - Country:US
Mailing Address - Phone:231-744-6661
Mailing Address - Fax:231-744-2837
Practice Address - Street 1:166 N CAUSEWAY ST
Practice Address - Street 2:
Practice Address - City:N MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-3302
Practice Address - Country:US
Practice Address - Phone:231-744-6661
Practice Address - Fax:231-744-2837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI9163122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI9163OtherDENTAL LICENSE
1841599230OtherNPI TYPE II
1528012697OtherNPI TYPE 1
1841599230OtherNPI TYPE II