Provider Demographics
NPI:1891682712
Name:NEW BOSTON FAMILY DENTAL
Entity type:Organization
Organization Name:NEW BOSTON FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-631-2118
Mailing Address - Street 1:4620 TROTTERS POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-6859
Mailing Address - Country:US
Mailing Address - Phone:231-631-2118
Mailing Address - Fax:
Practice Address - Street 1:37228 HURON RIVER DR
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:MI
Practice Address - Zip Code:48164-9286
Practice Address - Country:US
Practice Address - Phone:231-631-2118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty