Provider Demographics
NPI:1760586879
Name:HARTLAND FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:HARTLAND FAMILY DENTAL PLLC
Other - Org Name:DREW M SMITH DDS AND NORBERT A ZONCA DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-632-6444
Mailing Address - Street 1:12319 HIGHLAND
Mailing Address - Street 2:#100
Mailing Address - City:HARTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48353
Mailing Address - Country:US
Mailing Address - Phone:810-632-6444
Mailing Address - Fax:810-632-6491
Practice Address - Street 1:12319 HIGHLAND
Practice Address - Street 2:#100
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353
Practice Address - Country:US
Practice Address - Phone:810-632-6444
Practice Address - Fax:810-632-6491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018511122300000X
MI2901009967122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty