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General NPI Number Information
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NPI Number | 1538063524
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Entity Type | Organization
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Legal Business Name | LIFETIME DENTAL CARE OF MICHIGAN, P.C.
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 53233 HAYES RD
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-2110
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Country | US
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Telephone | 586-488-2445
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Fax | 586-488-2449
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Provider Business Mailing Address
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Address Line | 53233 HAYES RD
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-2110
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Country | US
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Telephone | 586-488-2445
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Fax | 586-488-2449
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | HILLARY THULL
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Credential |
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Telephone | 217-540-8946
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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 | NULL
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