Organization
LAKESIDE SMILES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E MEYER DDS (MEMBER)
(269) 561-2904
Entity
Organization
Contact information
Practice address
200 N MAPLE ST, FENNVILLE, MI 49408-8478
(269) 561-2904
Mailing address
200 N MAPLE ST, PO BOX 506, FENNVILLE, MI 49408-8478
(269) 561-2904
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13870
MI
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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