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Organization
GRAND TRAVERSE ORAL SURGERY, P.C.
Active
Organization
GRAND TRAVERSE ORAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN J. SCHLUETER (OFFICE MANAGER)
(231) 946-3512
Entity
Organization
Contact information
Practice address
12776 S WEST BAY SHORE DR, TRAVERSE CITY, MI 49684-5451
(231) 946-3512
(231) 946-1908
Mailing address
12776 S WEST BAY SHORE DR, TRAVERSE CITY, MI 49684-5451
(231) 946-3512
(231) 946-1908
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/31/2007
Last updated
03/19/2008
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