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1136 Country Club Rd Ste B Adrian MI 49221-8208 | |
| (517) 263-9022 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1136 Country Club Rd Ste B, Adrian, Michigan |
| Authorized Official Name and Position | Cassandra Petersen (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 2175408972 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1136 Country Club Rd Ste B Adrian MI 49221-8208 Ph: (517) 263-9022 | 1136 Country Club Rd Ste B Adrian MI 49221-8208 Ph: (517) 263-9022 |
| NPI Number | 1922500917 |
|---|---|
| Provider Enumeration Date | 03/06/2018 |
| Last Update Date | 03/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922500917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
John A Lark Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1136 Country Club Rd, Suite B, Adrian, MI 49221 Phone: 517-263-9022 Fax: 517-263-9155 | |
Michael P Towler Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 E Maple Ave, Adrian, MI 49221 Phone: 517-265-7411 Fax: 517-263-1050 | |
Richard B. Youngs,dds,pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 E Maple Ave, Adrian, MI 49221 Phone: 517-265-7411 Fax: 517-263-1050 |