Provider Demographics
NPI:1013090760
Name:PREFERENCE DENTAL PC
Entity Type:Organization
Organization Name:PREFERENCE DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HOSKING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-972-7104
Mailing Address - Street 1:7255 9 MILE RD
Mailing Address - Street 2:PO BOX 236
Mailing Address - City:MECOSTA
Mailing Address - State:MI
Mailing Address - Zip Code:49332-9344
Mailing Address - Country:US
Mailing Address - Phone:231-972-7104
Mailing Address - Fax:231-972-7250
Practice Address - Street 1:7255 9 MILE RD
Practice Address - Street 2:BOX 236
Practice Address - City:MECOSTA
Practice Address - State:MI
Practice Address - Zip Code:49332-9344
Practice Address - Country:US
Practice Address - Phone:231-972-7104
Practice Address - Fax:231-972-7250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0140901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID8081440OtherBCBS
MI014090OtherDELTA DENTAL