Organization
LIFETIME DENTAL CARE OF MICHIGAN, PC
Active
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, PC
Other names
The Lakes Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL CARE OF MICHIGAN, PC
Authorized official
KENDRA WALKER (CREDENTIALING TEAM LEAD)
(217) 540-8312
Entity
Organization
Contact information
Practice address
6127 RAWSONVILLE RD, SUITE 118, BELLEVILLE, MI 48111-2546
(734) 720-9827
Mailing address
6127 RAWSONVILLE RD, SUITE 118, BELLEVILLE, MI 48111-2546
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/09/2016
Last updated
02/29/2016
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