Provider Demographics
NPI:1376272476
Name:ST. HELEN FAMILY DENTISTRY
Entity Type:Organization
Organization Name:ST. HELEN FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:TOZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-389-4931
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:SAINT HELEN
Mailing Address - State:MI
Mailing Address - Zip Code:48656-0009
Mailing Address - Country:US
Mailing Address - Phone:989-389-4931
Mailing Address - Fax:989-389-3633
Practice Address - Street 1:631 N SAINT HELEN RD
Practice Address - Street 2:
Practice Address - City:SAINT HELEN
Practice Address - State:MI
Practice Address - Zip Code:48656-8543
Practice Address - Country:US
Practice Address - Phone:989-389-4931
Practice Address - Fax:989-389-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty