# DENTAL CENTER OF PLYMOUTH LLC

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

## Provider details

- **NPI number:** 1336516517
- **Authorized official:** MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
- **Authorized official phone:** (727) 726-1611

## Contact information

- **Practice address:** 1913 N MICHIGAN ST STE E, PLYMOUTH, IN 46563-1015
- **Practice address phone:** (574) 936-4123
- **Mailing address:** 1913 N MICHIGAN ST STE E, PLYMOUTH, IN 46563-1015

## Taxonomy

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

## Other

- **Enumeration date:** 08/24/2015
- **Last updated:** 08/24/2015