| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 785 E M 32, Gaylord, Michigan |
| Authorized Official Name and Position | Diane M Reinhardt (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 9894482664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
785 E M 32 Gaylord MI 49735-8790 Ph: (989) 448-2664 | 785 E M 32 Gaylord MI 49735-8790 Ph: (989) 448-2664 |
| NPI Number | 1629784970 |
|---|---|
| Provider Enumeration Date | 01/30/2023 |
| Last Update Date | 01/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629784970 | NPI | - | NPPES |
| 1194842468 | Other | MI | KRISTAL GRENIUK-WIONCEK DDS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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