Organization
BAY MILLS INDIAN COMMUNITY
Active
Other names
Bay Mills Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ABBY KAUNISTO (CLINIC COORDINATOR)
(906) 248-8315
Entity
Organization
Contact information
Practice address
12455 W LAKESHORE DR, BRIMLEY, MI 49715-9327
(906) 248-5527
(906) 248-5765
Mailing address
12455 W LAKESHORE DR, BRIMLEY, MI 49715-9327
(906) 248-5527
(906) 248-2572
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
OA76020
MI
Other
Enumeration date
04/26/2006
Last updated
11/16/2022
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