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Organization
POTOCKI PEDIATRIC DENTISTRY PLLC
Active
Organization
POTOCKI PEDIATRIC DENTISTRY PLLC
Active
Other names
Grass Lake Pediatric Dentistry and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISA POTOCKI DMD (OWNER DENTIST)
(248) 361-1512
Entity
Organization
Contact information
Practice address
12365 E MICHIGAN AVE, GRASS LAKE, MI 49240-8000
(517) 764-6283
Mailing address
12365 E MICHIGAN AVE, GRASS LAKE, MI 49240-8000
(517) 764-6283
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/15/2022
Last updated
04/15/2022
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