| Professional Corporation | |
|
609 E Jolly Road Suite 10b Lansing MI 48910 | |
| (517) 882-7132 | |
| (517) 882-6608 |
| Full Name | Professional Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 609 E Jolly Road, Lansing, Michigan |
| Authorized Official Name and Position | Patricia J Hart (GENERAL MANAGER) |
| Authorized Official Contact | 8102386260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Corporation 609 E Jolly Road Suite 10b Lansing MI 48910 Ph: (517) 882-7132 | Professional Corporation 609 E Jolly Road Suite 10b Lansing MI 48910 Ph: (517) 882-7132 |
| NPI Number | 1205928322 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205928322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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