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CASEVILLE FAMILY DENTISTRY PC NPI 1790215028


NPI Information

NPI: 1790215028
Provider Name: CASEVILLE FAMILY DENTISTRY, PC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 23D0915980

Address:
6982 MAIN ST
CASEVILLE, MI
ZIP 48725
Phone: (989) 856-4096
Get Directions

CASEVILLE FAMILY DENTISTRY, PC is a general practice dentist in Caseville, MI. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CASEVILLE FAMILY DENTISTRY, PC NPI is 1790215028. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6982 MAIN ST
CASEVILLE, MI
ZIP 48725-110
Phone: (989) 856-4096
Fax: (989) 856-4025

The provider's authorized official is Amy Redwantz .
The authorized official title is Manager and has the following contact phone number (989) 856-4096.

The CLIA number assigned to this NPI record is 23D0915980 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/19/2017 and was last updated on 6/19/2017.


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
11223G0001XDentistGeneral Practice15627MICHIGANYes

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
115627OTHERMICHIGANSTATE DENTAL LICENSE

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

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