| Potocki Pediatric Dentistry Pllc | |
|
12365 E Michigan Ave Grass Lake MI 49240-8000 | |
| (517) 764-6283 | |
| Not Available |
| Full Name | Potocki Pediatric Dentistry Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12365 E Michigan Ave, Grass Lake, Michigan |
| Authorized Official Name and Position | Melisa Potocki (OWNER DENTIST) |
| Authorized Official Contact | 2483611512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Potocki Pediatric Dentistry Pllc 12365 E Michigan Ave Grass Lake MI 49240-8000 Ph: (517) 764-6283 | Potocki Pediatric Dentistry Pllc 12365 E Michigan Ave Grass Lake MI 49240-8000 Ph: (517) 764-6283 |
| NPI Number | 1831832039 |
|---|---|
| Provider Enumeration Date | 04/15/2022 |
| Last Update Date | 04/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831832039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Grass Lake Dental Center Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11745 E Michigan Ave, Grass Lake, MI 49240 Phone: 517-522-5018 |