Organization
PINE RIVER DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE A NESTER DDS (OWNER)
(989) 875-2888
Entity
Organization
Contact information
Practice address
610 N PINE RIVER ST, ITHACA, MI 48847-1167
(989) 875-2888
(989) 875-4604
Mailing address
610 N PINE RIVER ST, ITHACA, MI 48847-1167
(989) 875-2888
(989) 875-4604
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12204
MI
1223G0001X
General Practice Dentistry
14779
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1519621
—
MI
Enumeration date
10/06/2008
Last updated
08/21/2013
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