Organization
BAY AREA ORAL & MAXILLOFACIAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUCINDA K MICHELIN (PRACTICE ADMINISTRATION)
(231) 933-1220
Entity
Organization
Contact information
Practice address
4110 COPPER RIDGE DR, SUITE 210, TRAVERSE CITY, MI 49684-6722
(231) 933-1220
(231) 933-1225
Mailing address
4110 COPPER RIDGE DR, SUITE 210, TRAVERSE CITY, MI 49684-6722
(231) 933-1220
(231) 933-1225
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901013774
MI
Other
Enumeration date
08/22/2008
Last updated
08/22/2008
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