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General NPI Number Information
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NPI Number | 1760553143
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Entity Type | Organization
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Legal Business Name | MICHAEL L MIANECKI DDS & JOHN P CARLINO DDS PC
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 51190 D W SEATON
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City | NEW BALTIMORE
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State | MI
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Zip | 48047
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Country | US
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Telephone | 586-725-9898
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Fax | 586-725-4470
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Provider Business Mailing Address
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Address Line | 51190 D W SEATON
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City | NEW BALTIMORE
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State | MI
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Zip | 48047
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Country | US
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Telephone | 586-725-9898
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Fax | 586-725-4470
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JOANN M TOMSHA
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Credential |
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Telephone | 586-725-9898
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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 | 16971
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 17456
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12534
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License Number State | MI
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