| Blue Water Dental Group Marysville Pc | |
|
1616 Gratiot Blvd Maryville MI 48040-1181 | |
| (810) 364-7601 | |
| (810) 364-9010 |
| Full Name | Blue Water Dental Group Marysville Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1616 Gratiot Blvd, Maryville, Michigan |
| Authorized Official Name and Position | William Lee Kile (PRESIDENT) |
| Authorized Official Contact | 8103647601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Water Dental Group Marysville Pc 1616 Gratiot Blvd Maryville MI 48040-1181 Ph: (810) 364-7601 | Blue Water Dental Group Marysville Pc 1616 Gratiot Blvd Maryville MI 48040-1181 Ph: (810) 364-7601 |
| NPI Number | 1508975319 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508975319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2901008847 (Michigan) | Primary |