| White Lake Family Dentistry | |
|
116 W Colby St Ste 1 Whitehall MI 49461-1084 | |
| (231) 893-2915 | |
| (231) 893-4719 |
| Full Name | White Lake Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 116 W Colby St Ste 1, Whitehall, Michigan |
| Authorized Official Name and Position | Grant Gillish (OWNER/DENTIST) |
| Authorized Official Contact | 2318932915 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Lake Family Dentistry 116 W Colby St Ste 1 Whitehall MI 49461-1084 Ph: (231) 893-2915 | White Lake Family Dentistry 116 W Colby St Ste 1 Whitehall MI 49461-1084 Ph: (231) 893-2915 |
| NPI Number | 1801319025 |
|---|---|
| Provider Enumeration Date | 07/19/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9830509561 |
|---|---|
| Medicare Enrollment ID | O20201106002327 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801319025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901020310 (Michigan) | Primary |
| Provider Name | Grant K Gillish |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1659681591 PECOS PAC ID: 5799088720 Enrollment ID: I20201222000947 |
Lakeshore Family Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 504 E Colby St, Whitehall, MI 49461 Phone: 231-894-8814 Fax: 231-893-6505 | |
Trinity Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 W Colby St, Ste 1, Whitehall, MI 49461 Phone: 231-893-2915 |