Organization
LIFETIME DENTAL OF MACOMB PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK OUSACHI (DIRECTOR OF OPERATIONS)
(586) 940-0123
Entity
Organization
Contact information
Practice address
28050 HARPER AVE, SAINT CLAIR SHORES, MI 48081-1562
(586) 774-6655
Mailing address
3024 MANGROVE DR, STERLING HEIGHTS, MI 48314-4407
(586) 940-0123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/18/2026
Last updated
05/18/2026
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