| Michigan Restorative Institute, Pllc | |
|
4036 24th Ave Fort Gratiot MI 48059-3800 | |
| (810) 385-9766 | |
| Not Available |
| Full Name | Michigan Restorative Institute, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 4036 24th Ave, Fort Gratiot, Michigan |
| Authorized Official Name and Position | Michael Schaaf (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 2692176442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Restorative Institute, Pllc 4036 24th Ave Fort Gratiot MI 48059-3800 Ph: (810) 385-9766 | Michigan Restorative Institute, Pllc 4036 24th Ave Fort Gratiot MI 48059-3800 Ph: (810) 385-9766 |
| NPI Number | 1356811756 |
|---|---|
| Provider Enumeration Date | 11/28/2018 |
| Last Update Date | 04/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356811756 | NPI | - | NPPES |
| 2901022154 | Other | MI | DENTAL LICENSE |
| 2901022068 | Other | MI | DENTAL LICENSE |
| 2901022057 | Other | MI | DENTAL LICENSE |
| 2901021060 | Other | MI | DENTAL LICENSE |
| 2901022368 | Other | MI | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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Michigan Restorative Institute, Pllc Dental Clinic Medicare: Medicare Enrolled Practice Location: 4036 24th Ave, Fort Gratiot, MI 48059 Phone: 810-385-9766 Fax: 810-990-8403 |