Provider Demographics
NPI:1205982618
Name:JAMES L. ABEREGG D.D.S.,P.C.
Entity type:Organization
Organization Name:JAMES L. ABEREGG D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ABEREGG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-242-0440
Mailing Address - Street 1:1050 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-3113
Mailing Address - Country:US
Mailing Address - Phone:734-243-0440
Mailing Address - Fax:
Practice Address - Street 1:1050 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3113
Practice Address - Country:US
Practice Address - Phone:734-243-0440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11676122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty