Organization
LAKE ODESSA DENTAL, PLLC
Active
Other names
Lake Odessa Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOSEPH CRETE DDS (MEMBER)
(616) 560-3625
Entity
Organization
Contact information
Practice address
1032 4TH AVE, LAKE ODESSA, MI 48849-1004
(616) 374-8828
(616) 374-7934
Mailing address
2101 SAN LU RAE DR SE, GRAND RAPIDS, MI 49506-3425
(616) 560-3625
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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