Great Lakes Family Dental Group Dexter, PC

NPI #1003191941 in Dexter, Michigan

Provider Information

NPI Number: 1003191941
Entity Type: Organization
Organization Name: Great Lakes Family Dental Group Dexter, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 11, 2011
Last Updated: Oct 11, 2011

Practice Location

Address: 3060 BAKER RD
City: Dexter
State: Michigan
ZIP Code: 48130-1140
Phone: (734) 426-4651

Authorized Official

Name: PATRICIA J. HART
Title: CORPORATE MANAGER
Phone: (810) 625-2860

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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