Organization
BLUE CARE NETWORK OF MICHIGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY DOLL A DOLL (RECP.)
(517) 322-8061
Entity
Organization
Contact information
Practice address
1401 S CREYTS RD, LANSING, MI 48917-8507
(517) 322-8049
(517) 322-4486
Mailing address
1401 S CREYTS RD, LANSING, MI 48917-8507
(517) 322-8049
(517) 322-4486
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
18503
MI
122300000X
Dentist
Primary
18754
MA
122300000X
Dentist
18854
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D800318
BCBSM
MI
Enumeration date
08/27/2007
Last updated
08/27/2007
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