| Grand Traverse Band Of Ottawa And Chippewa Indians | |
|
2300 N Stallman Road Peshawbestown MI 49682 | |
| (231) 534-7211 | |
| (231) 534-7460 |
| Full Name | Grand Traverse Band Of Ottawa And Chippewa Indians |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2300 N Stallman Road, Peshawbestown, Michigan |
| Authorized Official Name and Position | Lori E Chambers (MANAGER) |
| Authorized Official Contact | 2315347477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Traverse Band Of Ottawa And Chippewa Indians 2300 N Stallman Road Suite A Peshawbestown MI 49682 Ph: (231) 534-7211 | Grand Traverse Band Of Ottawa And Chippewa Indians 2300 N Stallman Road Peshawbestown MI 49682 Ph: (231) 534-7211 |
| NPI Number | 1508126517 |
|---|---|
| Provider Enumeration Date | 05/23/2012 |
| Last Update Date | 12/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508126517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 261QD0000X (Michigan) | Primary |