| Dr. Gary W. Mancewicz Dds | |
|
2351 Countrywood Dr Se Kentwood MI 49508-5295 | |
| (616) 455-3020 | |
| (616) 455-1397 |
| Full Name | Dr. Gary W. Mancewicz Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2351 Countrywood Dr Se, Kentwood, Michigan |
| Authorized Official Name and Position | Gary W Mancewicz (OWNER/DENTIST) |
| Authorized Official Contact | 6164553020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Gary W. Mancewicz Dds 2351 Countrywood Dr Se Kentwood MI 49508-5295 Ph: (616) 455-3020 | Dr. Gary W. Mancewicz Dds 2351 Countrywood Dr Se Kentwood MI 49508-5295 Ph: (616) 455-3020 |
| NPI Number | 1346508124 |
|---|---|
| Provider Enumeration Date | 04/30/2012 |
| Last Update Date | 04/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346508124 | NPI | - | NPPES |
| 4828774 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2901011327 (Michigan) | Primary |
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