MEDICARE: HARVEY DENTAL CLINIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	124Q00000X	Dental Hygienist
2	126800000X	Dental Assistant
3	122300000X	Dentist

General Provider Information

NPI Number	:	1801212451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARVEY DENTAL CLINIC PC

Provider Business Mailing Address
First Line	:	57 GRIMES RD
Second Line	:
City	:	NEGAUNEE
State	:	MI
Zip	:	49866-9600
Country	:	US
Telephone Number	:	906-401-0121
Fax Number	:

Provider Business Practice Location Address
First Line	:	2336 US 41 S
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-9122
Country	:	US
Telephone Number	:	906-249-1040
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRETT S GOYMERAC
Credential	:	DDS
Telephone Number	:	906-401-0121

Provider Enumeration Date	:	03/06/2014
Last Update Date	:	03/06/2014

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Directions to “HARVEY DENTAL CLINIC PC ” Practice Location

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