# GULL LAKE DENTAL CARE PC

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

## Provider details

- **NPI number:** 1841345014
- **Authorized official:** DR. TODD DUANE TUCKER DDS (PRESIDENT)
- **Authorized official phone:** (269) 629-9817

## Contact information

- **Practice address:** 9271 E D AVE, RICHLAND, MI 49083-9497
- **Practice address phone:** (269) 629-9817
- **Practice address fax:** (269) 629-0195
- **Mailing address:** 9271 E D AVE, PO BOX 9, RICHLAND, MI 49083-9497
- **Mailing address phone:** (269) 629-9817
- **Mailing address fax:** (269) 629-0195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 16980 | MI | Yes |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 08/22/2020