# OSHTEMO FAMILY DENTISTRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053484253
- **Authorized official:** DR. RICHARD KEVIN BANNOW D.D.S. (PRESIDENT)
- **Authorized official phone:** (269) 372-1042

## Contact information

- **Practice address:** 5917 STADIUM DR, KALAMAZOO, MI 49009-3017
- **Practice address phone:** (269) 372-1042
- **Practice address fax:** (269) 372-9962
- **Mailing address:** 5917 STADIUM DR, KALAMAZOO, MI 49009-3017
- **Mailing address phone:** (269) 372-1042
- **Mailing address fax:** (269) 372-9962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901012099 | MI | Yes |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 08/22/2020