Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 2901009355 | MI |
NPI | 1003998444 |
---|---|
Provider Name | Dr. William F Janelle |
First Address | Bingham Farms, MI 48025-4360 |
Second Address | Bingham Farms, MI 48025-4360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |