| N E W Up Dental | |
|
4103 10th St Menominee MI 49858-1309 | |
| (906) 863-2206 | |
| (906) 863-6389 |
| Full Name | N E W Up Dental |
|---|---|
| Speciality | Dentist |
| Location | 4103 10th St, Menominee, Michigan |
| Authorized Official Name and Position | Donald Thomas Park (HALF OWNER) |
| Authorized Official Contact | 9068632206 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| N E W Up Dental 4103 10th St Menominee MI 49858-1309 Ph: (906) 863-2206 | N E W Up Dental 4103 10th St Menominee MI 49858-1309 Ph: (906) 863-2206 |
| NPI Number | 1215194832 |
|---|---|
| Provider Enumeration Date | 05/21/2008 |
| Last Update Date | 05/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215194832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901010258 (Michigan) | Primary |
| 122300000X | Dentist | 2901017418 (Michigan) | Secondary |
Andrew J Thanos Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2012 10th St, Menominee, MI 49858 Phone: 906-863-9203 Fax: 906-863-9205 |