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Organization
TLC DENTAL OF WALLED LAKE, PLLC
Active
Organization
TLC DENTAL OF WALLED LAKE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KURT HEUERMAN DDS (OWNER)
(248) 624-4774
Entity
Organization
Contact information
Practice address
1264 S COMMERCE RD, WALLED LAKE, MI 48390-3008
(248) 624-4774
(248) 624-9256
Mailing address
1264 S COMMERCE RD, WALLED LAKE, MI 48390-3008
(248) 624-4774
(248) 624-9256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17214
MI
1223G0001X
General Practice Dentistry
18099
MI
1223G0001X
General Practice Dentistry
2901018746
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17087
DDS
MI
Enumeration date
09/21/2006
Last updated
08/22/2020
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