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General NPI Number Information
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NPI Number | 1700539939
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Entity Type | Organization
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Legal Business Name | GENERAL DENTISTRY OF MICHIGAN 2 PLLC
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 9310 TELEGRAPH RD
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City | TAYLOR
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State | MI
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Zip | 48180-3362
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Country | US
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Telephone | 313-523-4810
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Fax |
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Provider Business Mailing Address
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Address Line | 4874 MONTROSE AVE
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City | OKEMOS
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State | MI
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Zip | 48864-1618
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Country | US
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Telephone | 517-210-0204
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Fax |
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Authorized Official
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Title or Position | VP INSURANCE PLAN MANAGEMENT
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Name | MICHAEL COLE
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Credential |
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Telephone | 727-424-2990
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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 |
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License Number State |
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