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General NPI Number Information
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NPI Number | 1922485994
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Entity Type | Organization
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Legal Business Name | H. KEITH TREIBER, DDS FAMILY DENTISTRY P. C.
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 04/29/2015
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Provider Practice Location Address
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Address Line | 412 S LINCOLN AVE
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City | LAKEVIEW
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State | MI
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Zip | 48850-5004
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Country | US
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Telephone | 989-352-7752
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Fax | 989-352-8542
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Provider Business Mailing Address
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Address Line | PO BOX 80 412 LINCOLN AVE
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City | LAKEVIEW
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State | MI
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Zip | 48850-0080
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Country | US
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Telephone | 989-352-7752
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Fax | 989-352-8542
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DEBRA ANN TREIBER
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Credential |
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Telephone | 989-352-7752
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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 | 15275
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License Number State | MI
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