| Beacon Dental Center | |
|
1723 W M 32 Building B Gaylord MI 49735-9544 | |
| (989) 448-2802 | |
| (231) 547-5077 |
| Full Name | Beacon Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1723 W M 32, Gaylord, Michigan |
| Authorized Official Name and Position | Michael A Sullivan (OWNER / DOCTOR) |
| Authorized Official Contact | 2315479141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Dental Center 6483 M 66 N Charlevoix MI 49720-9272 Ph: (231) 547-9141 | Beacon Dental Center 1723 W M 32 Building B Gaylord MI 49735-9544 Ph: (989) 448-2802 |
| NPI Number | 1134599251 |
|---|---|
| Provider Enumeration Date | 10/01/2015 |
| Last Update Date | 10/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134599251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19909 (Michigan) | Primary |
| 1223G0001X | Dentist - General Practice | 13522 (Michigan) | Secondary |
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