| Mitch Ty Carpenter-thompson, | |
|
213 S Canal St, Lake City, MI 49651-8865 | |
| (231) 839-2630 | |
| Not Available |
| Full Name | Mitch Ty Carpenter-thompson |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | 213 S Canal St, Lake City, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134746290 | NPI | - | NPPES |
| 600446 | Other | MI | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 014317 (Michigan) | Secondary |
| 1223G0001X | Dentist - General Practice | 600446 (Michigan) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mitch Ty Carpenter-thompson, Po Box 719, Lake City, MI 49651-0719 Ph: (231) 839-2630 | Mitch Ty Carpenter-thompson, 213 S Canal St, Lake City, MI 49651-8865 Ph: (231) 839-2630 |
Dr. Michael Francis Lahey, DDS Dentist Medicare: Medicare Enrolled Practice Location: 301 N Main, Lake City, MI 49651 Phone: 231-839-4673 | |
Mrs. Susan L Shore-vignola, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 213 S Canal St, Lake City, MI 49651 Phone: 231-839-2630 Fax: 231-839-5751 |