Healthcare Provider Details

I. General information

NPI: 1336002658
Provider Name (Legal Business Name): DAHL DENTAL OF STOCKBRIDGE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E MAIN ST # 9482
STOCKBRIDGE MI
49285-9482
US

IV. Provider business mailing address

353 E BROOKS ST
HOWELL MI
48843-2309
US

V. Phone/Fax

Practice location:
  • Phone: 517-851-8455
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GRACE M DAHL
Title or Position: MANAGING MEMBER
Credential: DDS
Phone: 517-512-2617