Provider Demographics
NPI:1265694459
Name:JONATHAN J. BECHTEL D.D.S., P.C.
Entity type:Organization
Organization Name:JONATHAN J. BECHTEL D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:BECHTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-882-7132
Mailing Address - Street 1:609 E JOLLY RD
Mailing Address - Street 2:SUITE 10B
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-6801
Mailing Address - Country:US
Mailing Address - Phone:517-882-7132
Mailing Address - Fax:
Practice Address - Street 1:609 E JOLLY RD
Practice Address - Street 2:SUITE 10B
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-6801
Practice Address - Country:US
Practice Address - Phone:517-882-7132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI17632261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental