Provider Demographics
NPI:1356077580
Name:SHERILL L BEHNKE DDS, PC
Entity Type:Organization
Organization Name:SHERILL L BEHNKE DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEHNKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-332-6633
Mailing Address - Street 1:325 W LAKE LANSING RD STE C
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8524
Mailing Address - Country:US
Mailing Address - Phone:517-332-8663
Mailing Address - Fax:
Practice Address - Street 1:325 W LAKE LANSING RD STE C
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8524
Practice Address - Country:US
Practice Address - Phone:517-332-8663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental