Organization
NORTHERN FAMILY DENTAL PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN RAYMOND KWAPISZ DDS (OWNER)
(231) 547-4148
Entity
Organization
Contact information
Practice address
106 E GARFIELD AVE, CHARLEVOIX, MI 49720-1721
(231) 547-4148
(231) 547-5670
Mailing address
106 E GARFIELD AVE, CHARLEVOIX, MI 49720-1721
(231) 547-4148
(231) 547-5670
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K120098730197
—
MI
Enumeration date
04/20/2021
Last updated
06/07/2021
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