Organization
GREAT LAKES FAMILY DENTAL GROUP - TECUMSEH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA J HART (GENERAL MANAGER)
(810) 238-6260
Entity
Organization
Contact information
Practice address
3085 W RUSSELL RD, TECUMSEH, MI 49286
(517) 423-2135
(517) 423-0009
Mailing address
3085 W RUSSELL RD, TECUMSEH, MI 49286
(517) 423-2135
(517) 423-0009
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/28/2006
Last updated
08/22/2020
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