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Organization

MID MICHIGAN DENTAL IMPLANT CENTER, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID LEE DOCKHAM DDS, PC (PRESIDENT)
(866) 438-6464
Entity
Organization

Contact information

Practice address
800 N STATE ST STE 151, STANTON, MI 48888-9708
(866) 438-6464
(989) 831-9020
Mailing address
800 N STATE ST STE 151, STANTON, MI 48888-9708
(866) 438-6464
(989) 831-9020

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2901013734
MI
1223G0001X
General Practice Dentistry
Primary
MI

Other

Enumeration date
02/06/2018
Last updated
02/06/2018
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