Organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Active
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Other names
Capital Avenue Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
3620 CAPITAL AVE SW STE A, BATTLE CREEK, MI 49015-9348
(269) 979-1500
Mailing address
3620 CAPITAL AVE SW STE A, BATTLE CREEK, MI 49015-9348
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/16/2022
Last updated
02/16/2022
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