Shore-Vignola, Susan L
Shore-Vignola, Susan L is an sole proprietor health care provider with primary practice located at 213 S Canal St , Lake City MI 49651-7929. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Shore-Vignola, Susan L can be contacted via phone (231) 839-2630.Contact Information
Primary practice address
213 S Canal St
Lake City MI 49651-7929
Phone: (231) 839-2630
Fax: (231) 839-5751
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 2901014317 | Michigan |
Profile Details
| NPI number | 1952394439 |
|---|---|
| LBN Legal business name | Shore-Vignola, Susan L |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2005 |
| Last updated | May 3rd, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952394439 | NPPES |
| Michigan | MEDICAID | 4087824 |
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