| L'anse Family Dentistry Pc | |
|
15647 Nordstrom St Lanse MI 49946-8439 | |
| (906) 524-6420 | |
| (906) 524-6821 |
| Full Name | L'anse Family Dentistry Pc |
|---|---|
| Speciality | Dentist |
| Location | 15647 Nordstrom St, Lanse, Michigan |
| Authorized Official Name and Position | Mark G Summersett (DENTIST) |
| Authorized Official Contact | 9065246420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| L'anse Family Dentistry Pc Po Box 9 15647 Nordstrom St Lanse MI 49946-0009 Ph: (906) 524-6420 | L'anse Family Dentistry Pc 15647 Nordstrom St Lanse MI 49946-8439 Ph: (906) 524-6420 |
| NPI Number | 1801176169 |
|---|---|
| Provider Enumeration Date | 08/18/2011 |
| Last Update Date | 09/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801176169 | NPI | - | NPPES |
| 1778884 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901020319 (Michigan) | Secondary |
| 122300000X | Dentist | 2901013208 (Michigan) | Primary |