# LAKESIDE CENTER FOR IMPLANT DENTISTRY

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

## Provider details

- **NPI number:** 1235567694
- **Authorized official:** ALAN F ROBINSON D.D.S. (DENTIST)
- **Authorized official phone:** (586) 228-0909

## Contact information

- **Practice address:** 15400 19 MILE RD, SUITE 181, CLINTON TOWNSHIP, MI 48038-6327
- **Practice address phone:** (586) 228-0909
- **Mailing address:** 15400 19 MILE RD, SUITE 181, CLINTON TOWNSHIP, MI 48038-6327
- **Mailing address phone:** (586) 228-0909

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901013244 | MI | Yes |

## Other

- **Enumeration date:** 10/23/2013
- **Last updated:** 08/04/2014