# CASEVILLE FAMILY DENTAL, PLLC

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

## Provider details

- **NPI number:** 1114638467
- **Authorized official:** PETER WLOSZEK (OWNER)
- **Authorized official phone:** (586) 805-8052

## Contact information

- **Practice address:** 6982 MAIN ST, CASEVILLE, MI 48725-5110
- **Practice address phone:** (586) 805-8052
- **Mailing address:** 45861 KENSINGTON ST, UTICA, MI 48317-5962
- **Mailing address phone:** (586) 805-8052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | — |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/07/2022
- **Last updated:** 01/05/2023