Great Lakes Family Dental Group-St. Joseph

NPI #1598117616 in Saint Joseph, Michigan

Provider Information

NPI Number: 1598117616
Entity Type: Organization
Organization Name: Great Lakes Family Dental Group-St. Joseph
Primary Specialty: Dentist
Enumeration Date: Jul 13, 2016
Last Updated: Jul 13, 2016

Practice Location

Address: 2525 S CLEVELAND AVE
City: Saint Joseph
State: Michigan
ZIP Code: 49085-2649
Phone: (810) 625-2860

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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