LAKE ODESSA DENTAL, PLLC


Address: 1032 4th Ave, Lake Odessa, MI 48849-1004
Phone: 6163748828

LAKE ODESSA DENTAL, PLLC (NPI# 1851889471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851889471
Entity Type Organization
Organization Name LAKE ODESSA DENTAL, PLLC
Other Organization Name LAKE ODESSA DENTAL ASSOCIATES
Practice Address 1032 4th Ave
Lake Odessa
MI 48849-1004
Mailing Address 2101 San Lu Rae Dr Se
Grand Rapids
MI 49506-3425
Practice Telephone 6163748828
Practice Fax Number 6163747934
Mailing Telephone 6165603625
Enumeration Date 2018-04-30
Last Update Date 2018-04-30
Authorized Official Name DR. MICHAEL JOSEPH CRETE (MEMBER)
Authorized Official Telephone 6165603625
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Lake Odessa Dental Associates Doing Business As Name - Organization

Office Location

Street Address 1032 4TH AVE
City LAKE ODESSA
State MI
Zip Code 48849-1004

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215024369 Gerald T Licari Dds PC Dentist 1032 4th Ave, Lake Odessa, MI 48849-1004 2006-10-09
1790831402 Michael J Crete Dentist 1032 4th Ave, Lake Odessa, MI 48849-1004 2007-01-26
1376630327 Gerald T Licari Dentist 1032 4th Ave, Lake Odessa, MI 48849-1004 2006-10-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851512339 Christine Margaret Thomas Pharmacist 838 Fouth Ave, Lake Odessa, MI 48849 2007-05-01
1275641649 Advanced Rx LLC Pharmacy 838 4th Avenue, Lake Odessa, MI 48849 2006-08-27
1578580080 Total Health Center Hastings Inc Physical Therapist 4294 Laurel Dr, Ste 2, Lake Odessa, MI 48849 2006-07-17
1831608108 Lake Odessa Pharmacy Pharmacy 802 4th Ave, Lake Odessa, MI 48849-1002 2017-09-29
1104914001 William H Walker Pharmacist 838 4th Ave, Lake Odessa, MI 48849-1002 2006-10-10
1851340335 Catherine Hemingway Dental Hygienist 924 4th Ave, Lake Odessa, MI 48849-1003 2006-05-10
1639258320 Aaron Blane Freeman Dentist 924 4th Ave, Lake Odessa, MI 48849-1003 2006-11-03
1083133607 Vicki Davison Psychologist 1040 4th Ave, Lake Odessa, MI 48849-1004 2017-09-14
1558320846 Clarence Richard Barnett Family Medicine 1020 4th Ave, Lake Odessa, MI 48849-1004 2006-03-23
1447380324 Clarence Richard Barnett Md Plc Family Medicine 1020 4th Ave, Lake Odessa, MI 48849-1004 2007-03-07
Find all providers in zip 48849

Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144821216 Inspired Family Dental Care Clinic/Center 1685 Fairholme Rd, Grosse Pointe Woods, MI 48236-2368 2020-11-05
1376144261 Right Choice Dental, PC Clinic/Center 475 Columbia Ave E Ste 5, Battle Creek, MI 49014-5461 2020-11-05
1669073813 Thomas M Smith, Dds, Plc Clinic/Center 755 Seminole Rd Ste 103, Norton Shores, MI 49441-6561 2020-11-04
1235739533 Randy J Breen Dds Pllc Clinic/Center 2460 Burton St Se Ste 201, Grand Rapids, MI 49546-4800 2020-10-27
1831798370 Saline Dental Care, Pllc Clinic/Center 150 Judd Rd, Milan, MI 48160-9584 2020-10-24
1235738113 David Sorial Dds PC Clinic/Center 14755 Northline Rd, Southgate, MI 48195-2407 2020-10-21
1598363970 Steven M Moss Dds PC Clinic/Center 37625 Ann Arbor Rd Ste 108, Livonia, MI 48150-2400 2020-10-16
1700484375 Troy Cosmetic and Implant Dental Center Pllc Clinic/Center 4770 Rochester Rd Ste 106, Troy, MI 48085-4951 2020-10-15
1194323303 Aq Dental Group Pllc Clinic/Center 10413 Ford Road, Units M & N, Dearborn, MI 48126 2020-10-12
1245837806 Kendall J Lee Dds Pllc Clinic/Center 111 S Howell St, Hillsdale, MI 49242-1873 2020-10-07
Find all providers with the same taxonomy

Competitor

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City LAKE ODESSA
Zip Code 48849

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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