| Smile Zone Dental | |
|
4036 24th Ave Fort Gratiot MI 48059-3800 | |
| (810) 385-9766 | |
| (810) 990-8403 |
| Full Name | Smile Zone Dental |
|---|---|
| Speciality | Dentist |
| Location | 4036 24th Ave, Fort Gratiot, Michigan |
| Authorized Official Name and Position | Michael Schaaf (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 2692176442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Zone Dental 8096 Wimbledon Dr Portage MI 49024-7807 Ph: (269) 217-6442 | Smile Zone Dental 4036 24th Ave Fort Gratiot MI 48059-3800 Ph: (810) 385-9766 |
| NPI Number | 1871141093 |
|---|---|
| Provider Enumeration Date | 08/30/2019 |
| Last Update Date | 04/23/2021 |
| Medicare PECOS PAC ID | 5799184636 |
|---|---|
| Medicare Enrollment ID | O20210526002716 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871141093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Ahmed N Eldib |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1699117762 PECOS PAC ID: 5698071363 Enrollment ID: I20210526002827 |
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