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Organization
DENTISTRY ETC
Active
Organization
DENTISTRY ETC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL LEACH (OFFICE MANAGER)
(810) 695-4300
Entity
Organization
Contact information
Practice address
4025 E HILL RD, GRAND BLANC, MI 48439-7942
(810) 695-4300
(810) 695-2309
Mailing address
4025 E HILL RD, GRAND BLANC, MI 48439-7942
(810) 695-4300
(810) 695-2309
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12818
MI
Other
Enumeration date
11/20/2008
Last updated
11/20/2008
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