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General NPI Number Information
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NPI Number | 1174478796
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Entity Type | Organization
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Legal Business Name | MILLER CREEK FAMILY DENTAL PLLC
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 3337 S AIRPORT RD W STE 1
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-7927
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Country | US
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Telephone | 231-252-1033
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Fax | 231-252-1066
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Provider Business Mailing Address
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Address Line | 3337 S AIRPORT RD W STE 1
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-7927
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Country | US
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Telephone | 231-252-1033
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Fax | 231-252-1066
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Authorized Official
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Title or Position | DENTIST
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Name | DR. THOMAS J SHONIKER
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Credential | DMD
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Telephone | 231-492-3721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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