Organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Active
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Other names
Cherry Creek Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Authorized official
JESSICA BRITT (CREDENTIALING COORDINATOR)
(217) 540-5100
Entity
Organization
Contact information
Practice address
56060 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-5143
(586) 838-1152
Mailing address
56060 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-5143
(586) 838-1152
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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