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General NPI Number Information
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NPI Number | 1467501130
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Entity Type | Organization
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Legal Business Name | LANSING COMMUNITY COLLEGE
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 515 N. WASHINGTON SQ.
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City | LANSING
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State | MI
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Zip | 48933
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Country | US
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Telephone | 517-483-1458
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Fax | 517-483-9925
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Provider Business Mailing Address
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Address Line | PO BOX 40010 MC 3100 DENTAL HYGIENE PROGRAM
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City | LANSING
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State | MI
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Zip | 48901-7210
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Country | US
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Telephone | 517-483-1458
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Fax | 517-483-9925
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Authorized Official
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Title or Position | ACADEMIC TEAM LEADER - DENTAL PRGM.
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Name | MRS. SHERRY KOHLMANN
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Credential | MA, RDH, RDA
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Telephone | 517-483-1457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 88024
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License Number State | MI
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