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NPI Code Detail

MEDICARE: GARY FRANK SUCAET D.D.S.

MEDICARE:   GARY FRANK SUCAET  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry13343MI

General Provider Information

NPI Number : 1902928708
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY FRANK SUCAET D.D.S.
Provider Business Mailing Address
First Line : 3777 18 MILE RD
Second Line : SUITE #4
City : STERLING HEIGHTS
State : MI
Zip : 48314-3882
Country : US
Telephone Number : 586-254-4100
Fax Number : 586-254-6528
Provider Business Practice Location Address
First Line : 3777 18 MILE RD
Second Line : SUITE #4
City : STERLING HEIGHTS
State : MI
Zip : 48314-3882
Country : US
Telephone Number : 586-254-4100
Fax Number : 586-254-6528
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 07/08/2007

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Directions to “ GARY FRANK SUCAET D.D.S.” Practice Location

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