Organization
GULL LAKE DENTAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD DUANE TUCKER DDS (PRESIDENT)
(269) 629-9817
Entity
Organization
Contact information
Practice address
9271 E D AVE, RICHLAND, MI 49083-9497
(269) 629-9817
(269) 629-0195
Mailing address
9271 E D AVE, PO BOX 9, RICHLAND, MI 49083-9497
(269) 629-9817
(269) 629-0195
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16980
MI
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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