# CASSOPOLIS DENTAL, P.C.

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

## Provider details

- **NPI number:** 1558743690
- **Authorized official:** DR. JOHN HAYMAN JR. D.D.S. (OWNER DENTIST)
- **Authorized official phone:** (269) 445-8636

## Contact information

- **Practice address:** 62225 M 62, CASSOPOLIS, MI 49031-8733
- **Practice address phone:** (269) 445-8636
- **Practice address fax:** (269) 445-2891
- **Mailing address:** PO BOX 335, CASSOPOLIS, MI 49031-0335
- **Mailing address phone:** (269) 445-8636
- **Mailing address fax:** (269) 445-2891

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901015556 | MI | Yes |
| 1223G0001X | General Practice Dentistry | 2901021614 | MI | — |

## Other

- **Enumeration date:** 06/25/2015
- **Last updated:** 06/25/2015