Organization
MID-MICHIGAN PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MICHAEL SUSHYNSKI D.D.S., M.S. (MEMBER)
(810) 733-5310
Entity
Organization
Contact information
Practice address
1125 S LINDEN RD, SUITE 800, FLINT, MI 48532-4073
(810) 733-5310
(810) 733-1216
Mailing address
1125 S LINDEN RD, SUITE 800, FLINT, MI 48532-4073
(810) 733-5310
(810) 733-1216
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2901019960
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4060491
—
MI
Enumeration date
04/16/2008
Last updated
01/01/2014
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