Provider Demographics
NPI:1003416140
Name:DCM DENTISTRY, PLC
Entity Type:Organization
Organization Name:DCM DENTISTRY, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BAIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-444-6069
Mailing Address - Street 1:213 W ROCKWELL ST
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2078
Mailing Address - Country:US
Mailing Address - Phone:810-444-6069
Mailing Address - Fax:
Practice Address - Street 1:1535 N LEROY ST STE F
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2791
Practice Address - Country:US
Practice Address - Phone:810-629-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty