# MICHAEL L MIANECKI DDS & JOHN P CARLINO DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mianecki & Carlino DDS PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760553143
- **Authorized official:** MRS. JOANN M TOMSHA (OFFICE MANAGER)
- **Authorized official phone:** (586) 725-9898

## Contact information

- **Practice address:** 51190 D W SEATON, NEW BALTIMORE, MI 48047
- **Practice address phone:** (586) 725-9898
- **Practice address fax:** (586) 725-4470
- **Mailing address:** 51190 D W SEATON, NEW BALTIMORE, MI 48047
- **Mailing address phone:** (586) 725-9898
- **Mailing address fax:** (586) 725-4470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12534 | MI | Yes |
| 122300000X | Dentist | 16971 | MI | — |
| 122300000X | Dentist | 17456 | MI | — |

## Other

- **Enumeration date:** 11/10/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1805391 | — | MI |
| 01 | — | 3331437 | MEDICAID | MI |
| 01 | — | 4125193 | MEDICAID | MI |