# NORTHWOOD COSMETIC DENTAL GROUP, PC

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

## Provider details

- **NPI number:** 1366976854
- **Authorized official:** DR. BRIAN P KLYM DDS (OWNER DENTIST)
- **Authorized official phone:** (231) 947-7202

## Contact information

- **Practice address:** 10748 E TRAVERSE HWY, TRAVERSE CITY, MI 49684-5550
- **Practice address phone:** (231) 947-7202
- **Practice address fax:** (231) 933-3401
- **Mailing address:** 10748 E TRAVERSE HWY, TRAVERSE CITY, MI 49684-5550
- **Mailing address phone:** (231) 947-7202
- **Mailing address fax:** (231) 933-3401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901016991 | MI | Yes |

## Other

- **Enumeration date:** 04/12/2017
- **Last updated:** 04/12/2017