# BALDWIN LAKE DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Baldwin Lake Dental PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962116418
- **Authorized official:** DR. MARK LEVIN (DENTIST)
- **Authorized official phone:** (616) 754-2800

## Contact information

- **Practice address:** 322 S LAFAYETTE ST STE A, GREENVILLE, MI 48838-1965
- **Practice address phone:** (616) 754-2800
- **Mailing address:** 322 S LAFAYETTE ST STE A, GREENVILLE, MI 48838-1965
- **Mailing address phone:** (616) 754-2800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/10/2023
- **Last updated:** 01/10/2023