| Great Lakes Dental Group | |
|
115 E 14th St Traverse City MI 49684-3220 | |
| (231) 947-3790 | |
| (231) 947-3353 |
| Full Name | Great Lakes Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 115 E 14th St, Traverse City, Michigan |
| Authorized Official Name and Position | Frank Ken Catino (OWNER DENTIST) |
| Authorized Official Contact | 2319473790 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Dental Group 115 E 14th St Traverse City MI 49684-3220 Ph: (231) 947-3790 | Great Lakes Dental Group 115 E 14th St Traverse City MI 49684-3220 Ph: (231) 947-3790 |
| NPI Number | 1407900558 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407900558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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