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General NPI Number Information
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NPI Number | 1134220593
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Entity Type | Organization
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Legal Business Name | HOUGHTON LAKE DENTAL GROUP, PC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3185 W HOUGHTON LAKE DR
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City | HOUGHTON LAKE
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State | MI
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Zip | 48629-8242
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Country | US
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Telephone | 989-366-9621
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Fax | 989-366-8237
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Provider Business Mailing Address
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Address Line | 3185 W HOUGHTON LAKE DR
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City | HOUGHTON LAKE
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State | MI
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Zip | 48629-8242
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Country | US
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Telephone | 989-366-9621
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Fax | 989-366-8237
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH HOOD
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Credential |
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Telephone | 989-366-9621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17997
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17895
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 8779
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License Number State | MI
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