Organization
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS
Active
Other names
GTB Dental Clinc
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI E CHAMBERS (MANAGER)
(231) 534-7477
Entity
Organization
Contact information
Practice address
2300 N STALLMAN ROAD, PESHAWBESTOWN, MI 49682
(231) 534-7211
(231) 534-7460
Mailing address
2300 N STALLMAN ROAD, SUITE A, PESHAWBESTOWN, MI 49682
(231) 534-7211
(231) 534-7460
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
261QD0000X
MI
Other
Enumeration date
05/23/2012
Last updated
12/04/2013
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