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General NPI Number Information
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NPI Number | 1376859173
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Entity Type | Organization
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Legal Business Name | MID-MICHIGAN DISTRICT HEALTH DEPARTMENT
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 615 N STATE ST
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City | STANTON
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State | MI
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Zip | 48888-9702
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Country | US
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Telephone | 989-831-5237
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Fax | 989-831-3666
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Provider Business Mailing Address
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Address Line | 615 N STATE ST
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City | STANTON
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State | MI
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Zip | 48888-9702
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Country | US
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Telephone | 989-831-5237
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Fax | 989-831-5522
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATIVE SERVICES
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Name | MS. MELISSA SELBY
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Credential |
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Telephone | 989-831-3641
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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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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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