Provider Demographics
NPI:1700072543
Name:MY COMMUNITY DENTAL CENTERS INC
Entity type:Organization
Organization Name:MY COMMUNITY DENTAL CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-437-4741
Mailing Address - Street 1:2940 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8795
Mailing Address - Country:US
Mailing Address - Phone:231-437-4741
Mailing Address - Fax:231-582-2967
Practice Address - Street 1:2940 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8795
Practice Address - Country:US
Practice Address - Phone:231-437-4741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty