Provider Demographics
NPI:1588747604
Name:SAGINAW VALLEY ORTHODONTIC SPECIALISTS, P.C.
Entity type:Organization
Organization Name:SAGINAW VALLEY ORTHODONTIC SPECIALISTS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:989-792-2837
Mailing Address - Street 1:5355 COLONY DR N
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-7190
Mailing Address - Country:US
Mailing Address - Phone:989-792-2837
Mailing Address - Fax:989-792-2834
Practice Address - Street 1:5355 COLONY DR N
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-7190
Practice Address - Country:US
Practice Address - Phone:989-792-2837
Practice Address - Fax:989-792-2834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010090391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty