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Organization
MICHAEL GLASS FAMILY AND COSMETIC DENTRY
Active
Organization
MICHAEL GLASS FAMILY AND COSMETIC DENTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIE BLYTHE (OFFICE MGR)
(269) 963-9670
Entity
Organization
Contact information
Practice address
131 E COLUMBIA AVE, SUITE 101, BATTLE CREEK, MI 49015-3788
(269) 963-9670
(269) 963-9672
Mailing address
131 E COLUMBIA AVE, SUITE 101, BATTLE CREEK, MI 49015-3788
(269) 963-9670
(269) 963-9672
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4709263
—
MI
Enumeration date
02/23/2010
Last updated
02/23/2010
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