# NORTHERN MICHIGAN FAMILY DENTISTRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTHERN MICHIGAN FAMILY DENTISTRY PLLC
- **Other names:** Gaylord Family Dentistry, Cheboygan Family Dentistry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1437428364
- **Legal business name:** NORTHERN MICHIGAN FAMILY DENTISTRY PLLC
- **Authorized official:** NICOLE KOENIG (OFFICE MANAGER)
- **Authorized official phone:** (989) 732-4199

## Contact information

- **Practice address:** 10711 N STRAITS HWY, CHEBOYGAN, MI 49721-9077
- **Practice address phone:** (231) 627-9352
- **Practice address fax:** (231) 627-9411
- **Mailing address:** PO BOX 5215, CHEBOYGAN, MI 49721-5215
- **Mailing address phone:** (316) 279-3522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 17226 | MI | Yes |

## Other

- **Enumeration date:** 12/21/2011
- **Last updated:** 03/19/2018