Organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Active
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Other names
Jacobson Dental Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Authorized official
CEMYIRA MCDOUGAL (CREDENTIALING COORDINATOR)
(217) 764-8609
Entity
Organization
Contact information
Practice address
39890 W 14 MILE RD, COMMERCE TOWNSHIP, MI 48390-3911
(248) 624-8090
Mailing address
39890 W 14 MILE RD, COMMERCE TOWNSHIP, MI 48390-3911
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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