| Mitigoons Dental | |
|
204 E Portage Ave Sault Sainte Marie MI 49783-2054 | |
| (906) 248-5527 | |
| (906) 248-5765 |
| Full Name | Mitigoons Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 204 E Portage Ave, Sault Sainte Marie, Michigan |
| Authorized Official Name and Position | Audrey Breakie (HHS DIRCTOR) |
| Authorized Official Contact | 9062488315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mitigoons Dental 12455 W Lakeshore Dr Brimley MI 49715-9327 Ph: (906) 248-5527 | Mitigoons Dental 204 E Portage Ave Sault Sainte Marie MI 49783-2054 Ph: (906) 248-5527 |
| NPI Number | 1366409237 |
|---|---|
| Provider Enumeration Date | 04/26/2006 |
| Last Update Date | 06/20/2023 |
| Medicare PECOS PAC ID | 8729079918 |
|---|---|
| Medicare Enrollment ID | O20240104002493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366409237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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