Organization
LAKSHORE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW BARGREN (OWNER)
(269) 429-4661
Entity
Organization
Contact information
Practice address
5638 CLEVELAND AVE, STEVENSVILLE, MI 49127-9696
(269) 429-4661
(269) 429-4486
Mailing address
5638 CLEVELAND AVE, STEVENSVILLE, MI 49127-9696
(269) 429-4661
(269) 429-4486
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019195
MI
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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