Organization
MICHAEL GLASS FAMILY AND COSMETIC DENTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIE BLYTHE (OFFICE MGR)
(269) 963-9670
Entity
Organization
Contact information
Practice address
131 E COLUMBIA AVE, SUITE 101, BATTLE CREEK, MI 49015-3788
(269) 963-9670
(269) 963-9672
Mailing address
131 E COLUMBIA AVE, SUITE 101, BATTLE CREEK, MI 49015-3788
(269) 963-9670
(269) 963-9672
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4709263
—
MI
Enumeration date
02/23/2010
Last updated
02/23/2010
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