Provider Demographics
NPI:1407566250
Name:YALE DENTAL CARE
Entity Type:Organization
Organization Name:YALE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-304-0924
Mailing Address - Street 1:7727 BROCKWAY RD
Mailing Address - Street 2:
Mailing Address - City:BROCKWAY
Mailing Address - State:MI
Mailing Address - Zip Code:48097-3411
Mailing Address - Country:US
Mailing Address - Phone:810-387-4545
Mailing Address - Fax:
Practice Address - Street 1:7727 BROCKWAY RD
Practice Address - Street 2:
Practice Address - City:BROCKWAY
Practice Address - State:MI
Practice Address - Zip Code:48097-3411
Practice Address - Country:US
Practice Address - Phone:810-387-4545
Practice Address - Fax:810-387-9736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental