Gerald T Licari DDS PC

NPI #1215024369 in Lake Odessa, Michigan

Provider Information

NPI Number: 1215024369
Entity Type: Organization
Organization Name: Gerald T Licari DDS PC
Primary Specialty: Dentist
Enumeration Date: Oct 9, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1032 4TH AVE
City: Lake Odessa
State: Michigan
ZIP Code: 48849-1004
Phone: (616) 374-8828

Authorized Official

Name: DR. GERALD T LICARI, DDS
Title: PRESIDENT
Phone: (616) 374-8828

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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DR. Gerald T Licari, DDS	Dentist	Lake Odessa	AI Deep Dive
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