Provider Demographics
NPI:1306901962
Name:CHRISTINE A. LOVE D.D.S., M.S. PLC
Entity type:Organization
Organization Name:CHRISTINE A. LOVE D.D.S., M.S. PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS PLC
Authorized Official - Phone:810-220-2789
Mailing Address - Street 1:8641 W. GRAND RIVER
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-4330
Mailing Address - Country:US
Mailing Address - Phone:810-220-2789
Mailing Address - Fax:810-220-4935
Practice Address - Street 1:8641 W. GRAND RIVER
Practice Address - Street 2:SUITE 8
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-4330
Practice Address - Country:US
Practice Address - Phone:810-220-2789
Practice Address - Fax:810-220-4935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0126551223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty