institution
Northern Michigan Pediatric Dentistry
Dental Clinic/Center in Traverse City, Michigan
NPI 1275685265

Northern Michigan Pediatric Dentistry is a Dental Clinic/Center based in Traverse City, MI and is specialized in Dental. Northern Michigan Pediatric Dentistry practices in Traverse City, MI. The NPI Number for Northern Michigan Pediatric Dentistry is 1275685265 and holds a License No. 2901017484 (Michigan).

The current practice location address for Northern Michigan Pediatric Dentistry is 4944 Skyview Ct, Traverse City, MI and can be reached out via phone at 231-947-4566.

Location: 4944 Skyview Ct, Traverse City, MI, 49684-7173
institution
Provider Profile Details
NPI Number
1275685265
Provider Name
Northern Michigan Pediatric Dentistry
Credential
Provider Entity Type
Organization
Address
4944 Skyview Ct, Traverse City, MI, 49684-7173
Phone Number
231-947-4566
Fax Number
Provider Enumeration Date
01/18/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4457700 01 MI MEDICAID
D158620 01 MI BLUE CROSS BLUE SHIELD MI
institution
Provider Business Practice Location Address Details
Address
4944 Skyview Ct
City
State
Zip
49684-7173
Phone Number
231-947-4566
Fax Number
person
Provider Business Mailing Address Details
Address
4944 Skyview Ct
City
State
Zip
49684-7173
Phone Number
231-947-4566
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
2901017484 (Michigan)
Definition
Definition to come...
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