# BLUE CARE NETWORK OF MICHIGAN

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

## Provider details

- **NPI number:** 1831382407
- **Authorized official:** KATHY DOLL A DOLL (RECP.)
- **Authorized official phone:** (517) 322-8061

## Contact information

- **Practice address:** 1401 S CREYTS RD, LANSING, MI 48917-8507
- **Practice address phone:** (517) 322-8049
- **Practice address fax:** (517) 322-4486
- **Mailing address:** 1401 S CREYTS RD, LANSING, MI 48917-8507
- **Mailing address phone:** (517) 322-8049
- **Mailing address fax:** (517) 322-4486

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 18503 | MI | — |
| 122300000X | Dentist | 18754 | MA | Yes |
| 122300000X | Dentist | 18854 | MI | — |

## Other

- **Enumeration date:** 08/27/2007
- **Last updated:** 08/27/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | D800318 | BCBSM | MI |