Organization
MARTINSONDRISCOLL D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE JO SWENOR (OFFICE MANAGER)
(231) 347-7471
Entity
Organization
Contact information
Practice address
2050 M 119, PETOSKEY, MI 49770-8962
(231) 347-7471
(231) 347-7836
Mailing address
2050 M 119, PETOSKEY, MI 49770-8962
(231) 347-7471
(231) 347-7836
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D811511
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/30/2006
Last updated
08/22/2020
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