Northern Dental Group, PC
Organization Active NPI Dentist · Pellston, MI
NPI 1629265293 · NPPES record last updated Sep 27, 2007
Key facts
- NPI
- 1629265293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 29010-16726 (MI)
- Legal business name
- NORTHERN DENTAL GROUP, PC
- Practice address
- 421 Stimpson St.
Pellston, MI 49769-0275 - Phone
- (231) 539-8467
- Fax
- (231) 539-8466
- NPI assigned
- Sep 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Patricia Ann Soper
- Title
- Treatment Coordinator
- Phone
- (231) 539-8467
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 29010-16726 | MI | Yes |
| Dentist |
122300000X | 29010-17732 | MI |
Addresses
Primary practice location
421 Stimpson St.
Pellston, MI 49769-0275
Mailing address
P.O. Box 275
421 Stimpson St.
Pellston, MI 49769-0275
Phone (231) 539-8467
Other providers in Pellston, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.