Organization
LENAWEE DENTAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ANTHONY LARK DDS (PRESIDENT BOARD OF DIRECTORS)
(517) 263-9022
Entity
Organization
Contact information
Practice address
128 S BROAD ST, ADRIAN, MI 49221-2723
(517) 266-0651
(517) 266-8476
Mailing address
128 S BROAD ST, ADRIAN, MI 49221-2723
(517) 266-0651
(517) 266-8476
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18869
MI
Other
Enumeration date
04/11/2007
Last updated
08/22/2020
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