Healthcare Provider Details

I. General information

NPI: 1134034952
Provider Name (Legal Business Name): CLEARY FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6231 N CANTON CENTER RD STE 103
CANTON MI
48187-2692
US

IV. Provider business mailing address

6231 N CANTON CENTER RD STE 103
CANTON MI
48187-2692
US

V. Phone/Fax

Practice location:
  • Phone: 734-619-8878
  • Fax:
Mailing address:
  • Phone: 734-619-8878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LONNITA LOUISE CLEARY
Title or Position: OWNER
Credential: D.D.S.
Phone: 734-619-8878