Provider Demographics
NPI:1689893521
Name:LAPEER DENTAL CENTRE MGT INC
Entity Type:Organization
Organization Name:LAPEER DENTAL CENTRE MGT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF ORGANIZATION
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:M
Authorized Official - Last Name:MUTCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-664-4542
Mailing Address - Street 1:381 N SAGINAW
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446
Mailing Address - Country:US
Mailing Address - Phone:810-664-4542
Mailing Address - Fax:810-664-3580
Practice Address - Street 1:381 N SAGINAW
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446
Practice Address - Country:US
Practice Address - Phone:810-664-4542
Practice Address - Fax:810-664-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty