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Organization

MID-MICHIGAN DISTRICT HEALTH DEPARTMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MELISSA SELBY (DIRECTOR OF ADMINISTRATIVE SERVICES)
(989) 831-3641
Entity
Organization

Contact information

Practice address
615 N STATE ST, STANTON, MI 48888-9702
(989) 831-5237
(989) 831-3666
Mailing address
615 N STATE ST, STANTON, MI 48888-9702
(989) 831-5237
(989) 831-5522

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
1223G0001X
General Practice Dentistry

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2901018840
DENTAL
MI
Enumeration date
08/31/2010
Last updated
07/26/2021
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