# LAKE MICHIGAN DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hallas Palaszek & Warber DDS PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164548640
- **Authorized official:** MICHAEL SCOTT PALASZEK DDS (PARTNER)
- **Authorized official phone:** (616) 453-8211

## Contact information

- **Practice address:** 2150 LAKE MICHIGAN DRIVE NW, GRAND RAPIDS, MI 49504-4798
- **Practice address phone:** (616) 453-8211
- **Practice address fax:** (616) 453-3277
- **Mailing address:** 2150 LAKE MICHIGAN DRIVE NW, GRAND RAPIDS, MI 49504-4798
- **Mailing address phone:** (616) 453-8211
- **Mailing address fax:** (616) 453-3277

## Taxonomy

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

## Other

- **Enumeration date:** 03/22/2007
- **Last updated:** 03/26/2012