Gull Lake Dental Care PC
Organization Active NPI Dentist · Richland, MI
NPI 1841345014 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1841345014
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 16980 (MI)
- Legal business name
- GULL LAKE DENTAL CARE PC
- Practice address
- 9271 E D Ave
Richland, MI 49083-9497 - Phone
- (269) 629-9817
- Fax
- (269) 629-0195
- NPI assigned
- Jan 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Todd Duane Tucker, DDS
- Title
- President
- Phone
- (269) 629-9817
Practitioners 1
-
Todd Duane Tucker, DDS
National Provider Directory
Locations
9271 E D Ave
Richland, MI 49083
Phone (269) 629-9817
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 16980 | MI | Yes |
Addresses
Primary practice location
9271 E D Ave
Richland, MI 49083-9497
Mailing address
9271 E D Ave
PO Box 9
Richland, MI 49083-9497
Phone (269) 629-9817
Other providers in Richland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.