Healthcare Provider Details

I. General information

NPI: 1083846026
Provider Name (Legal Business Name): CONTEMPORARY DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 W LAWRENCE AVE
CHARLOTTE MI
48813-1309
US

IV. Provider business mailing address

917 W LAWRENCE AVE
CHARLOTTE MI
48813-1309
US

V. Phone/Fax

Practice location:
  • Phone: 517-543-1840
  • Fax: 517-543-8780
Mailing address:
  • Phone: 517-543-1840
  • Fax: 517-543-8780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901020026
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901012173
License Number StateMI

VIII. Authorized Official

Name: DR. JEFFREY M MAIER
Title or Position: PRESIDENT
Credential: DDS
Phone: 517-543-1840