| Manistique Dental Center, P.c. | |
|
115 N Lake St Lowr Level Manistique MI 49854-1234 | |
| (906) 341-6132 | |
| (906) 341-3054 |
| Full Name | Manistique Dental Center, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 115 N Lake St Lowr Level, Manistique, Michigan |
| Authorized Official Name and Position | Gregory David Lafayette (PRESIDENT) |
| Authorized Official Contact | 9063416132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manistique Dental Center, P.c. 115 N Lake St Lowr Level Manistique MI 49854-1234 Ph: (906) 341-6132 | Manistique Dental Center, P.c. 115 N Lake St Lowr Level Manistique MI 49854-1234 Ph: (906) 341-6132 |
| NPI Number | 1093980955 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093980955 | NPI | - | NPPES |
| 1558410902 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901016294 (Michigan) | Primary |