Provider Demographics
NPI:1730248600
Name:JAMES L. SOUERS,D.D.S., ORTHODONTIST, P.C.
Entity type:Organization
Organization Name:JAMES L. SOUERS,D.D.S., ORTHODONTIST, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:SOUERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PC
Authorized Official - Phone:269-273-9595
Mailing Address - Street 1:111 E KELSEY ST
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-1503
Mailing Address - Country:US
Mailing Address - Phone:269-273-9595
Mailing Address - Fax:269-278-8071
Practice Address - Street 1:111 E KELSEY ST
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-1503
Practice Address - Country:US
Practice Address - Phone:269-273-9595
Practice Address - Fax:269-278-8071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010100331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty