Provider Demographics
NPI:1891860425
Name:HARTLAND DENTAL GROUP
Entity Type:Organization
Organization Name:HARTLAND DENTAL GROUP
Other - Org Name:JOSEPH R SMULSKY DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMULSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-632-5183
Mailing Address - Street 1:11525 HIGHLAND RD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:HARTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48353-2726
Mailing Address - Country:US
Mailing Address - Phone:810-632-5183
Mailing Address - Fax:810-632-5687
Practice Address - Street 1:11525 HIGHLAND RD
Practice Address - Street 2:SUITE 21
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353-2726
Practice Address - Country:US
Practice Address - Phone:810-632-5183
Practice Address - Fax:810-632-5687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI91991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty