Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Gerald T Licari DDS PC

Organization Dentist · NPI 1215024369

Gerald T Licari DDS PC provides Dentist services in Lake Odessa, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1032 4th Ave
Lake Odessa, MI 48849-1004
Phone: (616) 374-8828
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 2901011834 (MI)

Record details

NPI number1215024369
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gerald Licari — President · (616) 374-8828
NPI enumeratedOctober 9, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1032 4th Ave, Lake Odessa, MI 48849-1004

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