Organization
MICHIGAN RESTORATIVE INSTITUTE, PLLC
Active
Other names
New Era Dental, Smile Zone Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SCHAAF (DIRECTOR OF OPERATIONS)
(269) 217-6442
Entity
Organization
Contact information
Practice address
4036 24TH AVE, FORT GRATIOT, MI 48059-3800
(810) 385-9766
Mailing address
4036 24TH AVE, FORT GRATIOT, MI 48059-3800
(810) 385-9766
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901021060
DENTAL LICENSE
MI
01
—
2901022057
DENTAL LICENSE
MI
01
—
2901022068
DENTAL LICENSE
MI
01
—
2901022154
DENTAL LICENSE
MI
01
—
2901022368
DENTAL LICENSE
MI
Enumeration date
11/28/2018
Last updated
04/23/2021
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