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Organization
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS
Active
Organization
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS
Active
Other names
GTB Dental Clinc
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI E CHAMBERS (MANAGER)
(231) 534-7477
Entity
Organization
Contact information
Practice address
2300 N STALLMAN ROAD, PESHAWBESTOWN, MI 49682
(231) 534-7211
(231) 534-7460
Mailing address
2300 N STALLMAN ROAD, SUITE A, PESHAWBESTOWN, MI 49682
(231) 534-7211
(231) 534-7460
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
261QD0000X
MI
Other
Enumeration date
05/23/2012
Last updated
12/04/2013
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