Provider Demographics
NPI:1588833792
Name:FAMILY DENTISTRY OF SANDUSKY PC
Entity Type:Organization
Organization Name:FAMILY DENTISTRY OF SANDUSKY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-648-2522
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:MI
Mailing Address - Zip Code:48471-0071
Mailing Address - Country:US
Mailing Address - Phone:810-648-2522
Mailing Address - Fax:810-648-1916
Practice Address - Street 1:595 S SANDUSKY RD
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:MI
Practice Address - Zip Code:48471-9314
Practice Address - Country:US
Practice Address - Phone:810-648-2522
Practice Address - Fax:810-648-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty