Provider Demographics
NPI:1588919419
Name:GENERATIONS FAMILY DENTISTRY
Entity type:Organization
Organization Name:GENERATIONS FAMILY DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-686-7174
Mailing Address - Street 1:800 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-3355
Mailing Address - Country:US
Mailing Address - Phone:989-686-7174
Mailing Address - Fax:989-686-1860
Practice Address - Street 1:800 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3355
Practice Address - Country:US
Practice Address - Phone:989-686-7174
Practice Address - Fax:989-686-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty