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General NPI Number Information
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NPI Number | 1336002658
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Entity Type | Organization
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Legal Business Name | DAHL DENTAL OF STOCKBRIDGE PLLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 120 E MAIN ST # 9482
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City | STOCKBRIDGE
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State | MI
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Zip | 49285-9482
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Country | US
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Telephone | 517-851-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 353 E BROOKS ST
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City | HOWELL
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State | MI
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Zip | 48843-2309
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. GRACE M DAHL
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Credential | DDS
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Telephone | 517-512-2617
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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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