Organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Active
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Other names
Wolf Creek Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Authorized official
CASSANDRA PETERSEN (CREDENTIALING TEAM LEAD)
(217) 540-8972
Entity
Organization
Contact information
Practice address
1136 COUNTRY CLUB RD STE B, ADRIAN, MI 49221-8208
(517) 263-9022
Mailing address
1136 COUNTRY CLUB RD STE B, ADRIAN, MI 49221-8208
(517) 263-9022
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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