Blue Water Dental Group Marysville Pc | |
1616 Gratiot Blvd Maryville MI 48040-1181 | |
(810) 364-7601 | |
(810) 364-9010 |
Full Name | Blue Water Dental Group Marysville Pc |
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Speciality | Dentist - General Practice |
Location | 1616 Gratiot Blvd, Maryville, Michigan |
Authorized Official Name and Position | William Lee Kile (PRESIDENT) |
Authorized Official Contact | 8103647601 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Blue Water Dental Group Marysville Pc 1616 Gratiot Blvd Maryville MI 48040-1181 Ph: (810) 364-7601 | Blue Water Dental Group Marysville Pc 1616 Gratiot Blvd Maryville MI 48040-1181 Ph: (810) 364-7601 |
NPI Number | 1508975319 |
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Provider Enumeration Date | 08/29/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1508975319 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 2901008847 (Michigan) | Primary |