| Great Lakes Family Dental Group-livonia, P.c. | |
|
16160 Middlebelt Rd Livonia MI 48154-3338 | |
| (734) 261-9696 | |
| Not Available |
| Full Name | Great Lakes Family Dental Group-livonia, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 16160 Middlebelt Rd, Livonia, Michigan |
| Authorized Official Name and Position | C Patrick Gray (OWNER/PRESIDENT) |
| Authorized Official Contact | 8107320200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Family Dental Group-livonia, P.c. G3222 Beecher Rd Flint MI 48532-3614 Ph: (810) 230-3245 | Great Lakes Family Dental Group-livonia, P.c. 16160 Middlebelt Rd Livonia MI 48154-3338 Ph: (734) 261-9696 |
| NPI Number | 1497077630 |
|---|---|
| Provider Enumeration Date | 02/15/2010 |
| Last Update Date | 02/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497077630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 122300000X (Michigan) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 1223S0112X (Michigan) | Secondary |
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