# MID-MICHIGAN DENTAL ASSOCIATES PLC GLADWIN

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

## Provider details

- **NPI number:** 1104947878
- **Authorized official:** LAURA LEE CONEY R.D.H. (OFFICE MANAGER)
- **Authorized official phone:** (989) 426-6341

## Contact information

- **Practice address:** 200 W CEDAR AVE, GLADWIN, MI 48624-2020
- **Practice address phone:** (989) 426-6341
- **Practice address fax:** (989) 426-6411
- **Mailing address:** 200 W CEDAR AVE, GLADWIN, MI 48624-2020
- **Mailing address phone:** (989) 426-6341
- **Mailing address fax:** (989) 426-6411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 015374 | MI | Yes |
| 122300000X | Dentist | 019185 | MI | — |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 07/02/2008