# PELTON GLOVER DENTAL PC

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

## Provider details

- **NPI number:** 1083011233
- **Authorized official:** JOHN MICHAEL PELTON DDS (PRESIDENT)
- **Authorized official phone:** (586) 731-3131

## Contact information

- **Practice address:** 13610 24 MILE RD, SHELBY TOWNSHIP, MI 48315-2400
- **Practice address phone:** (586) 731-3131
- **Mailing address:** 13610 24 MILE RD, SHELBY TOWNSHIP, MI 48315-2400
- **Mailing address phone:** (586) 731-3131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 13626 | MI | — |
| 1223G0001X | General Practice Dentistry | 14192 | MI | Yes |

## Other

- **Enumeration date:** 12/02/2014
- **Last updated:** 12/02/2014