David Lee Dockham, DDS PC

Individual provider Active NPI General Practice Dentistry · Stanton, MI

NPI 1659440428 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1659440428
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
13734 (MI)
Practice address
800 North State Rd
Stanton, MI 48888
Phone
(989) 831-9200
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
13734MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stanton Family Dental Care PLLC Past
since Nov 8, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13734 MI Yes

Addresses

Primary practice location

800 North State Rd
Stanton, MI 48888

Mailing address

800 North State Rd
Stanton, MI 48888
Phone (989) 831-9200

Other providers in Stanton, MI

All providers in Stanton, MI · General Practice Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.