| Grand Traverse Oral Surgery, P.c. | |
|
12776 S West Bay Shore Dr Traverse City MI 49684-5451 | |
| (231) 946-3512 | |
| (231) 946-1908 |
| Full Name | Grand Traverse Oral Surgery, P.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 12776 S West Bay Shore Dr, Traverse City, Michigan |
| Authorized Official Name and Position | Susan J. Schlueter (OFFICE MANAGER) |
| Authorized Official Contact | 2319463512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Traverse Oral Surgery, P.c. 12776 S West Bay Shore Dr Traverse City MI 49684-5451 Ph: (231) 946-3512 | Grand Traverse Oral Surgery, P.c. 12776 S West Bay Shore Dr Traverse City MI 49684-5451 Ph: (231) 946-3512 |
| NPI Number | 1003095605 |
|---|---|
| Provider Enumeration Date | 10/31/2007 |
| Last Update Date | 03/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003095605 | NPI | - | NPPES |
| 0P21110 | Other | MI | MEDICARE GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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