# LAKE CITY FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1528686748
- **Authorized official:** MRS. BETH A MARSH (INSURANCE COORDINATOR)
- **Authorized official phone:** (231) 839-2630

## Contact information

- **Practice address:** 213 S CANAL ST, LAKE CITY, MI 49651-8865
- **Practice address phone:** (231) 839-2630
- **Practice address fax:** (231) 839-5751
- **Mailing address:** 213 S. CANAL ST, PO BOX 719, LAKE CITY, MI 49651
- **Mailing address phone:** (231) 839-2630
- **Mailing address fax:** (231) 839-5751

## Taxonomy

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

## Other

- **Enumeration date:** 07/14/2020
- **Last updated:** 07/14/2020