Dwight, Gary Harold

Dwight, Gary Harold is an individual health care provider with primary practice located at 818 W Lake Lansing Rd , East Lansing MI 48823-1308. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. Dwight, Gary Harold can be contacted via phone (517) 333-9500.

Contact Information

Primary practice address
818 W Lake Lansing Rd East Lansing MI 48823-1308
Phone: (517) 333-9500
Fax: (517) 333-9509
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Pathology 1223P0106X D10120 Michigan

Profile Details

NPI number 1255333431
LBN Legal business name Dwight, Gary Harold
Credentials D.D.S., M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Apr 2nd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255333431 NPPES
Michigan MEDICAID 4045412
Michigan MEDICAID 2985740

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