# MICHAEL P MCNUTT D.D.S., P.C.

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

## Provider details

- **NPI number:** 1669648945
- **Authorized official:** DR. MICHAEL PATRICK MCNUTT D.D.S. (OWNER)
- **Authorized official phone:** (248) 624-5996

## Contact information

- **Practice address:** 1881 N PONTIAC TRL, SUITE A, WALLED LAKE, MI 48390-3101
- **Practice address phone:** (248) 624-5996
- **Practice address fax:** (248) 624-5997
- **Mailing address:** 1881 N PONTIAC TRL, SUITE A, WALLED LAKE, MI 48390-3101
- **Mailing address phone:** (248) 624-5996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901016532 | MI | Yes |

## Other

- **Enumeration date:** 05/06/2008
- **Last updated:** 05/06/2008