Blue Water Family Dentistry Pc

NPI 1396756615 - Dentist - 122300000X

NPI Details
NPI 1396756615
Enumeration Date 08/11/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name WILLIAM SCOTT WILLIAM
Position DENTIST
Phone (810) 385-2273
Fax (810) 385-6285
Practice Location
4044 24TH AVE
FORT GRATIOT MI, 48059, US
Phone (810) 385-2273
Fax (810) 385-6285
Business Location
4044 24TH AVE
FORT GRATIOT MI, 48059, US
Phone (810) 385-2273
Fax (810) 385-6285
Toxanomy
Taxonomy Code 122300000X
License State Michigan
License Number 16113
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According to our database, Blue Water Family Dentistry Pc NPI is 1396756615, taxonomy code is 122300000X and license number is 16113, license state is located at Michigan. Blue Water Family Dentistry Pc physically located at 4044 24th Ave, Fort Gratiot MI, 48059. NPI Number 1033115704 has the healthcare provider type.

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1396756615 NPI number is provided on an as is basis without warranty of any kind. 1396756615 is maintained by the National Plan & Provider Enumeration System. The contents of Blue Water Family Dentistry Pc are for informational purposes only.