# GREAT LAKES FAMILY DENTAL GROUP BLISSFIELD PC

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

## Provider details

- **NPI number:** 1386835999
- **Authorized official:** MRS. PATRICIA J HART (GENERAL MANAGER)
- **Authorized official phone:** (810) 625-2860

## Contact information

- **Practice address:** 9178 E US 223, GREAT LAKES FAMILY DENTAL GROUP BLISSFIELD PC, BLISSFIELD, MI 49228
- **Practice address phone:** (517) 486-2030
- **Practice address fax:** (517) 486-4414
- **Mailing address:** 9178 E US 223, BLISSFIELD, MI 49228
- **Mailing address phone:** (517) 486-2030
- **Mailing address fax:** (517) 486-4414

## Taxonomy

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

## Other

- **Enumeration date:** 08/08/2007
- **Last updated:** 08/08/2007