Organization
MICHAEL J. CUSATIS DDS PLLC
Active
Other names
Oral Surgery Specialists of Northern MI
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J. CUSATIS DDS (OWNER)
(989) 732-4189
Entity
Organization
Contact information
Practice address
1507 S OTSEGO AVE STE B, GAYLORD, MI 49735-9524
(989) 732-4189
(989) 732-1916
Mailing address
1507 S OTSEGO AVE STE B, GAYLORD, MI 49735-9524
(989) 732-4189
(989) 732-1916
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D14500
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5190276
—
MI
Enumeration date
10/09/2008
Last updated
11/04/2008
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