MARK J LODGE

GRAND BLANC, MI
NPI1609906791
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: MI  2901015757)
Enumeration Date2007-03-07
Last Update Date2007-07-08
Business Address
-- MARK J LODGE DDS
134 HIGH ST
GRAND BLANC, MI 48439-1335
Phone number: 810-694-8073
Mailing Address
-- MARK J LODGE DDS
134 HIGH ST
GRAND BLANC, MI 48439-1335
Phone number: 810-694-8073