Great Lakes Dental, INC

NPI #1285977173 in North Scituate, Rhode Island

Provider Information

NPI Number: 1285977173
Entity Type: Organization
Organization Name: Great Lakes Dental, INC
Primary Specialty: Dentist
Enumeration Date: Mar 29, 2013
Last Updated: Mar 29, 2013

Practice Location

Address: 26 HARTFORD PIKE
City: North Scituate
State: Rhode Island
ZIP Code: 02857-1865
Phone: (401) 934-2666

Authorized Official

Name: DR. KENPAN HU, DMD
Title: PRESIDENT
Phone: (617) 319-7110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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