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Individual

DR. GARY HAROLD DWIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
818 W LAKE LANSING RD, EAST LANSING, MI 48823-1308
(517) 333-9500
(517) 333-9509
Mailing address
6400 PINE HOLLOW DR, EAST LANSING, MI 48823-9737
(517) 339-1812

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
D10120
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2985740
MI
05
4045412
MI
Enumeration date
06/01/2005
Last updated
04/02/2008
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