| Great Smile Dentistry | |
|
2201 Ludington St Escanaba MI 49829-2322 | |
| (906) 786-4033 | |
| (906) 786-9199 |
| Full Name | Great Smile Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2201 Ludington St, Escanaba, Michigan |
| Authorized Official Name and Position | Randy J Bogaudo (PRESIDENT) |
| Authorized Official Contact | 9067864033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Smile Dentistry 2201 Ludington St Escanaba MI 49829-2322 Ph: (906) 786-4033 | Great Smile Dentistry 2201 Ludington St Escanaba MI 49829-2322 Ph: (906) 786-4033 |
| NPI Number | 1194946418 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194946418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 15587 (Michigan) | Primary |
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