# MUSCOTT & MUSCOTT DENTAL HEALTH CENTER, PLC

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

## Provider details

- **NPI number:** 1346341187
- **Authorized official:** DR. DOUGLAS ERNEST MUSCOTT D.D.S. (DENTIST)
- **Authorized official phone:** (616) 527-6777

## Contact information

- **Practice address:** 2264 S STATE RD, IONIA, MI 48846-2149
- **Practice address phone:** (616) 527-6777
- **Practice address fax:** (616) 527-4647
- **Mailing address:** 2264 S STATE RD, PO BOX 510, IONIA, MI 48846-2149
- **Mailing address phone:** (616) 527-6777
- **Mailing address fax:** (616) 527-4647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901013792 | MI | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | D800208 | BLUE CROSS BLUE SHIELD | MI |