# MICHIGAN DENTURE & IMPLANT CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MICHIGAN DENTURE & IMPLANT CENTER PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1609033406
- **Legal business name:** MICHIGAN DENTURE & IMPLANT CENTER PC
- **Authorized official:** LARENCE J VERNIER D D S (OWNER)
- **Authorized official phone:** (586) 779-6777

## Contact information

- **Practice address:** 22855 KELLY RD, EASTPOINTE, MI 48021-2057
- **Practice address phone:** (586) 779-6777
- **Practice address fax:** (586) 779-0926
- **Mailing address:** 22855 KELLY RD, EASTPOINTE, MI 48021-2057
- **Mailing address phone:** (586) 779-6777
- **Mailing address fax:** (586) 779-0926

## Taxonomy

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

## Other

- **Enumeration date:** 05/20/2008
- **Last updated:** 05/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 800328 | BCBS | MI |