| Stag Dental | |
|
116 W Main St Kingsley MI 49649-5109 | |
| (231) 642-2042 | |
| Not Available |
| Full Name | Stag Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 116 W Main St, Kingsley, Michigan |
| Authorized Official Name and Position | David Erik Richard Burke (OWNER/DOCTOR) |
| Authorized Official Contact | 2316422042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stag Dental Po Box 518 Kingsley MI 49649-0518 Ph: (231) 642-2042 | Stag Dental 116 W Main St Kingsley MI 49649-5109 Ph: (231) 642-2042 |
| NPI Number | 1528565009 |
|---|---|
| Provider Enumeration Date | 04/10/2018 |
| Last Update Date | 01/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528565009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 802133003 (Michigan) | Primary |