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Organization
GREAT LAKES ORAL SURGERY AND IMPLANTS, P.C.
Active
Organization
GREAT LAKES ORAL SURGERY AND IMPLANTS, P.C.
Active
Parent organization
GREAT LAKES ORAL SURGERY AND IMPLANTS, P.C.
Other names
Greater Michigan Oral Surgeons & Dental Implant Center, Oral and Maxillofacial Surgery, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT LAKES ORAL SURGERY AND IMPLANTS, P.C.
Authorized official
SAMANTHA A KERN (CREDENTIALING & BILLING)
(810) 424-0705
Entity
Organization
Contact information
Practice address
5417 GATEWAY CTR, FLINT, MI 48507-3980
(810) 424-0705
(810) 424-0750
Mailing address
5417 GATEWAY CENTRE BLVD., FLINT, MI 48507-3980
(810) 424-0705
(810) 424-0750
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/10/2006
Last updated
08/28/2024
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