| Seven Lakes Periodontics | |
|
1100 Torrey Rd Suite 500 Fenton MI 48430-3327 | |
| (810) 750-3400 | |
| Not Available |
| Full Name | Seven Lakes Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1100 Torrey Rd, Fenton, Michigan |
| Authorized Official Name and Position | Diego Velasquez-plata (PRESIDENT) |
| Authorized Official Contact | 8107503400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Seven Lakes Periodontics 1100 Torrey Rd Suite 500 Fenton MI 48430-3327 Ph: (810) 750-3400 | Seven Lakes Periodontics 1100 Torrey Rd Suite 500 Fenton MI 48430-3327 Ph: (810) 750-3400 |
| NPI Number | 1922086370 |
|---|---|
| Provider Enumeration Date | 01/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922086370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 18270 (Michigan) | Primary |
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