# GLDE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great Lakes Dental Excellence
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427698851
- **Authorized official:** MS. MARY BETH HEGEDUS (PRAC ADMIN)
- **Authorized official phone:** (231) 799-0404

## Contact information

- **Practice address:** 5978 HARVEY ST, MUSKEGON, MI 49444-6720
- **Practice address phone:** (231) 799-0404
- **Practice address fax:** (231) 799-0014
- **Mailing address:** 5978 HARVEY ST, MUSKEGON, MI 49444-6720
- **Mailing address phone:** (231) 799-0404
- **Mailing address fax:** (231) 799-0014

## Taxonomy

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

## Other

- **Enumeration date:** 01/14/2020
- **Last updated:** 01/14/2020