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General NPI Number Information
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NPI Number | 1295696698
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Entity Type | Organization
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Legal Business Name | PURE NORTH DENTISTRY PLLC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 604 GALEN ST
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City | GRAYLING
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State | MI
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Zip | 49738-8788
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Country | US
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Telephone | 810-705-2576
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 111
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City | CARO
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State | MI
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Zip | 48723-0111
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Country | US
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Telephone | 810-705-2576
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DENNIS T SPILLANE
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Credential | DDS
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Telephone | 810-705-2576
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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 |
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License Number State |
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