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General NPI Number Information
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NPI Number | 1689645053
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH PROFESSIONALS
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 01/27/2012
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Provider Practice Location Address
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Address Line | 7800 US 131 S
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City | CADILLAC
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State | MI
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Zip | 49601-8437
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Country | US
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Telephone | 231-775-9797
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Fax | 231-775-9793
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Provider Business Mailing Address
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Address Line | 7800 US 131 S
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City | CADILLAC
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State | MI
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Zip | 49601-8437
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Country | US
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Telephone | 231-775-9797
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Fax | 231-775-9793
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL E. LUEDER
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Credential | D.D.S.
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Telephone | 231-775-9797
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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 | 11025
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 11842
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15351
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19225
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 11088
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License Number State | MI
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