Organization
DCP OF MICHIGAN (LAKESIDE), P.C.
Active
Parent organization
DENTALONE PARTNERS, INC
Other names
DentalWorks
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTALONE PARTNERS, INC
Authorized official
CHARLES SMITH DDS (DENTIST/OWNER)
(586) 296-1943
Entity
Organization
Contact information
Practice address
14100 LAKESIDE CIR, STERLING HEIGHTS, MI 48313-1322
(586) 566-9916
(216) 584-1046
Mailing address
PO BOX 860036, MINNEAPOLIS, MN 55486
(216) 584-1000
(216) 332-7503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
2901015672
MI
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
01/26/2006
Last updated
12/09/2016
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