| Mrs Susan L Shore-vignola, DDS | |
|
213 S Canal St, Lake City, MI 49651-7929 | |
| (231) 839-2630 | |
| (231) 839-5751 |
| Full Name | Mrs Susan L Shore-vignola |
|---|---|
| Gender | Female |
| Speciality | Dentist - General Practice |
| Location | 213 S Canal St, Lake City, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952394439 | NPI | - | NPPES |
| 4087824 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2901014317 (Michigan) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Susan L Shore-vignola, DDS Po Box 719, Lake City, MI 49651-0719 Ph: (231) 839-2630 | Mrs Susan L Shore-vignola, DDS 213 S Canal St, Lake City, MI 49651-7929 Ph: (231) 839-2630 |
Mitch Ty Carpenter-thompson, Dentist Medicare: Not Enrolled in Medicare Practice Location: 213 S Canal St, Lake City, MI 49651 Phone: 231-839-2630 | |
Dr. Michael Francis Lahey, DDS Dentist Medicare: Medicare Enrolled Practice Location: 301 N Main, Lake City, MI 49651 Phone: 231-839-4673 |