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Organization
ACCESS DENTAL GROUP PLLC
Active
Organization
ACCESS DENTAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA HAGIE (OFFICE MANAGER)
(231) 935-8461
Entity
Organization
Contact information
Practice address
431 MUNSON AVE STE C, TRAVERSE CITY, MI 49686-3060
(231) 935-8461
(231) 935-8467
Mailing address
431 MUNSON AVE STE C, TRAVERSE CITY, MI 49686-3060
(231) 935-8461
(231) 935-8467
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
012813
MI
1223G0001X
General Practice Dentistry
012865
MI
1223G0001X
General Practice Dentistry
Primary
014902
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
823434
UNITED CONCORDIA
PA
01
—
D802395
BCBS OF MI
MI
01
—
D80295
BCBS OF MS
MI
Enumeration date
09/08/2006
Last updated
12/29/2022
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