Copper Country Orthodontist, P.C.

Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Hancock, MI

NPI 1417009259 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1417009259
Entity type
Organization (NPI type 2)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
2901011868 (MI)
Legal business name
COPPER COUNTRY ORTHODONTIST, P.C.
Practice address
124 Quincy St
Hancock, MI 49930-1827
Phone
(906) 482-0015
Fax
(906) 482-3225
NPI assigned
Jan 18, 2007
Organization subpart
No

Authorized official

Name
Dr. Suazn Marie Stacknik, D.D.S., M.S.
Title
President Owner
Phone
(906) 482-0015

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

124 Quincy St
Hancock, MI 49930
Phone (906) 482-0015

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223X0400X 2901011868 MI Yes

Addresses

Primary practice location

124 Quincy St
Hancock, MI 49930-1827

Mailing address

124 Quincy St
Hancock, MI 49930-1827
Phone (906) 482-0015

Other providers in Hancock, MI

All providers in Hancock, MI · Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.