| Lake City Family Dentistry | |
|
213 S Canal St Lake City MI 49651-8865 | |
| (231) 839-2630 | |
| (231) 839-5751 |
| Full Name | Lake City Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 213 S Canal St, Lake City, Michigan |
| Authorized Official Name and Position | Mitch Ty Carpenter-thompson (OWNER/DENTIST) |
| Authorized Official Contact | 2318392630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake City Family Dentistry 213 S Canal St Po Box 719 Lake City MI 49651 Ph: (231) 839-2630 | Lake City Family Dentistry 213 S Canal St Lake City MI 49651-8865 Ph: (231) 839-2630 |
| NPI Number | 1912572124 |
|---|---|
| Provider Enumeration Date | 05/21/2021 |
| Last Update Date | 05/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912572124 | NPI | - | NPPES |
| 600446 | Other | MI | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Judy Wybenga, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 N Main St, Lake City, MI 49651 Phone: 231-839-4673 Fax: 231-838-7874 | |
Lake City Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 S Canal St, Lake City, MI 49651 Phone: 231-839-2630 Fax: 231-839-5751 | |
Four Seasons Dental Associates Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Main St, Lake City, MI 49651 Phone: 231-839-4673 Fax: 231-839-7874 |