L'anse Family Dentistry Pc | |
15647 Nordstrom St Lanse MI 49946-8439 | |
(906) 524-6420 | |
(906) 524-6821 |
Full Name | L'anse Family Dentistry Pc |
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Speciality | Dentist |
Location | 15647 Nordstrom St, Lanse, Michigan |
Authorized Official Name and Position | Mark G Summersett (DENTIST) |
Authorized Official Contact | 9065246420 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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L'anse Family Dentistry Pc Po Box 9 15647 Nordstrom St Lanse MI 49946-0009 Ph: (906) 524-6420 | L'anse Family Dentistry Pc 15647 Nordstrom St Lanse MI 49946-8439 Ph: (906) 524-6420 |
NPI Number | 1801176169 |
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Provider Enumeration Date | 08/18/2011 |
Last Update Date | 09/01/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801176169 | NPI | - | NPPES |
1778884 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 2901013208 (Michigan) | Primary |
122300000X | Dentist | 2901020319 (Michigan) | Secondary |