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Organization
L'ANSE FAMILY DENTISTRY PC
Active
Organization
L'ANSE FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK G SUMMERSETT DDS (DENTIST)
(906) 524-6420
Entity
Organization
Contact information
Practice address
15647 NORDSTROM ST, LANSE, MI 49946-8439
(906) 524-6420
(906) 524-6821
Mailing address
PO BOX 9, 15647 NORDSTROM ST, LANSE, MI 49946-0009
(906) 524-6420
(906) 524-6821
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901013208
MI
122300000X
Dentist
2901020319
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1778884
—
MI
Enumeration date
08/18/2011
Last updated
09/01/2011
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