Organization
LISA M MUSGRAVE DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA M MUSGRAVE DDS (SOLE PROPRIETOR)
(231) 882-9683
Entity
Organization
Contact information
Practice address
124 S BENZIE BLVD, BEULAH, MI 49617-8546
(231) 882-9683
(231) 882-5192
Mailing address
124 S BENZIE BLVD, PO BOX 378, BEULAH, MI 49617-8546
(231) 882-9683
(231) 882-5192
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901021135
MI
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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