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General NPI Number Information
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NPI Number | 1558228080
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Entity Type | Organization
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Legal Business Name | KALAMAZOO SMILES ON DRAKE
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1624 S DRAKE RD
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City | KALAMAZOO
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State | MI
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Zip | 49006-5780
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Country | US
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Telephone | 269-345-1455
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Fax | 269-978-0313
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Provider Business Mailing Address
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Address Line | 1624 S DRAKE RD
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City | KALAMAZOO
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State | MI
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Zip | 49006-5780
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Country | US
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Telephone | 269-345-1455
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Fax | 269-978-0313
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BARBARA MCPHALL
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Credential |
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Telephone | 269-345-1455
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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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