# GREAT LAKES FAMILY DENTAL GROUP-DEWITT, P.C.

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

## Provider details

- **NPI number:** 1801055009
- **Authorized official:** PATRICIA J. HART (CORPORATE MANAGER)
- **Authorized official phone:** (810) 625-2860

## Contact information

- **Practice address:** 13109 SCHAVEY RD, DEWITT, MI 48820-9015
- **Practice address phone:** (517) 669-2415
- **Mailing address:** 13109 SCHAVEY RD, DEWITT, MI 48820-9015
- **Mailing address phone:** (517) 669-2415

## Taxonomy

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

## Other

- **Enumeration date:** 06/03/2008
- **Last updated:** 06/05/2008