Manistique Dental Center, P.c. | |
115 N Lake St Lowr Level Manistique MI 49854-1234 | |
(906) 341-6132 | |
(906) 341-3054 |
Full Name | Manistique Dental Center, P.c. |
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Speciality | Dentist |
Location | 115 N Lake St Lowr Level, Manistique, Michigan |
Authorized Official Name and Position | Gregory David Lafayette (PRESIDENT) |
Authorized Official Contact | 9063416132 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Manistique Dental Center, P.c. 115 N Lake St Lowr Level Manistique MI 49854-1234 Ph: (906) 341-6132 | Manistique Dental Center, P.c. 115 N Lake St Lowr Level Manistique MI 49854-1234 Ph: (906) 341-6132 |
NPI Number | 1093980955 |
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Provider Enumeration Date | 04/22/2008 |
Last Update Date | 04/22/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093980955 | NPI | - | NPPES |
1558410902 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 2901016294 (Michigan) | Primary |