# CAVANAUGH DENTAL PLLC

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

## Provider details

- **NPI number:** 1124584396
- **Authorized official:** DR. DANIEL J. DERKSEN DDS (MEMBER)
- **Authorized official phone:** (517) 371-5342

## Contact information

- **Practice address:** 900 E CAVANAUGH RD, LANSING, MI 48910-5624
- **Practice address phone:** (517) 371-5374
- **Mailing address:** 2410 LAKE LANSING RD STE 2, LANSING, MI 48912-3659
- **Mailing address phone:** (517) 371-5342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 02/13/2019
- **Last updated:** 02/13/2019