NORTHERN FAMILY DENTAL PLC NPI 1053992057

NPI Information

NPI: 1053992057
Provider Name: NORTHERN FAMILY DENTAL PLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
106 E GARFIELD AVE
CHARLEVOIX, MI
ZIP 49720
Phone: (231) 547-4148
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NORTHERN FAMILY DENTAL PLC is a dental clinic center in Charlevoix, MI. NORTHERN FAMILY DENTAL PLC NPI is 1053992057. The provider is registered as an organization entity type.

The provider's business location address is:

106 E GARFIELD AVE
CHARLEVOIX, MI
ZIP 49720-721
Phone: (231) 547-4148
Fax: (231) 547-5670

The provider's authorized official is Brian Raymond Kwapisz .
The authorized official title is Owner and has the following contact phone number (231) 547-4148.

The enumeration date for this NPI number is 4/20/2021 and was last updated on 6/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	K120098730197	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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