Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grand Traverse Oral Surgery, PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1003095605

Grand Traverse Oral Surgery, PC is an Oral and Maxillofacial Surgery (Dentist) in Traverse City, Michigan. Registered with an NPI since 2007.

In the registry since
2007
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

12776 S West Bay Shore Dr
Traverse City, MI 49684-5451
Phone: (231) 946-3512
Fax: (231) 946-1908
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1003095605
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Susan Schlueter — Office Manager · (231) 946-3512
NPI enumeratedOctober 31, 2007
Last updated in NPPESMarch 19, 2008
Mailing address12776 S West Bay Shore Dr, Traverse City, MI 49684-5451

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