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BLUE WATER DENTAL GROUP MARYSVILLE PC
NPI 1508975319
Dentist - General Practice in Maryville, MI

Active since August 29, 2006
1616 GRATIOT BLVD, MARYVILLE, MI 48040(810) 364-7601(810) 364-9010 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Blue Water Dental Group Marysville Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE WATER DENTAL GROUP MARYSVILLE PC (NPI 1508975319) is a healthcare organization registered as a general practice in Maryville, Michigan and active in the NPI registry since August 2006. The organization lists William Lee Kile, President, as its authorized official.

NPPES Registry Identity

NPI1508975319
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBLUE WATER DENTAL GROUP MARYSVILLE PC
Location Address1616 GRATIOT BLVDMaryville, MI 48040-1181
Mailing Address1616 Gratiot BlvdMaryville, MI 48040-1181 · (810) 364-7601 · Fax (810) 364-9010
Phone(810) 364-7601
Fax(810) 364-9010
Organization SubpartNo
Authorized OfficialWilliam Lee KilePresident · (810) 364-7601
Enumeration DateAugust 29, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1508975319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MI · 2901008847
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1616 GRATIOT BLVD, Maryville, MI 48040
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SHANE MICHAEL LANGOLF DMD
Dentist (General Practice)
1616 GRATIOT BLVD
MARYSVILLE, MI 48040
St. Clair County (810) 364-7601
PGS D-PROVIDER DENTISTRY PLLC
Dentist (General Practice)
1616 GRATIOT BLVD
MARYSVILLE, MI 48040
St. Clair County (586) 727-3815

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blue Water Dental Group Marysville PC's NPI number?

The NPI number for Blue Water Dental Group Marysville PC is 1508975319. It was assigned to this organization in the NPPES registry on August 29, 2006.

Where is Blue Water Dental Group Marysville PC located?

Blue Water Dental Group Marysville PC is located at 1616 Gratiot Blvd, Maryville, MI 48040. The listed phone number is (810) 364-7601.

What is Blue Water Dental Group Marysville PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Blue Water Dental Group Marysville PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.