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Organization
HART FAMILY DENTISTRY PLLC
Active
Organization
HART FAMILY DENTISTRY PLLC
Active
Other names
Hart Lake Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT KURTIS GILLISH DDS (DENTIST/OWNER)
(231) 873-4025
Entity
Organization
Contact information
Practice address
110 S DRYDEN ST, HART, MI 49420-1105
(231) 873-4025
Mailing address
110 S DRYDEN ST, HART, MI 49420-1105
(231) 873-4025
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/02/2020
Last updated
07/23/2020
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