Organization
GARY H. DWIGHT, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY H DWIGHT D.D.S., M.S. (PRESIDENT)
(517) 333-9500
Entity
Organization
Contact information
Practice address
818 W LAKE LANSING RD, EAST LANSING, MI 48823-1308
(517) 333-9500
(517) 333-9509
Mailing address
818 W LAKE LANSING RD, EAST LANSING, MI 48823-1308
(517) 333-9500
(517) 333-9509
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
10120
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200000001267
PHP
MI
05
—
4045412
—
MI
Enumeration date
02/07/2008
Last updated
03/31/2010
Update your record
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