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Organization
MICHIGAN RESTORATIVE INSTITUTE, PLLC
Active
Organization
MICHIGAN RESTORATIVE INSTITUTE, PLLC
Active
Other names
New Era Dental, Smile Zone Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SCHAAF (DIRECTOR OF OPERATIONS)
(269) 217-6442
Entity
Organization
Contact information
Practice address
4036 24TH AVE, FORT GRATIOT, MI 48059-3800
(810) 385-9766
Mailing address
4036 24TH AVE, FORT GRATIOT, MI 48059-3800
(810) 385-9766
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901021060
DENTAL LICENSE
MI
01
—
2901022057
DENTAL LICENSE
MI
01
—
2901022068
DENTAL LICENSE
MI
01
—
2901022154
DENTAL LICENSE
MI
01
—
2901022368
DENTAL LICENSE
MI
Enumeration date
11/28/2018
Last updated
04/23/2021
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