Provider Demographics
NPI:1053862532
Name:ACME DENTAL HEALTH CARE PLLC
Entity Type:Organization
Organization Name:ACME DENTAL HEALTH CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SPILLANE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-705-2576
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-0111
Mailing Address - Country:US
Mailing Address - Phone:810-705-2576
Mailing Address - Fax:
Practice Address - Street 1:4480 MOUNT HOPE RD
Practice Address - Street 2:STE A
Practice Address - City:WILLIAMSBURG
Practice Address - State:MI
Practice Address - Zip Code:49690-9209
Practice Address - Country:US
Practice Address - Phone:231-486-6878
Practice Address - Fax:231-486-6877
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTAL HEALTH CARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901013854122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty