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

Great Lakes Oral and Maxillofacial Surgery PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1760008528

Great Lakes Oral and Maxillofacial Surgery PC is an Oral and Maxillofacial Surgery (Dentist) in Petoskey, Michigan. Registered with an NPI since 2020.

In the registry since
2020
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

2325 Summit Park Dr Ste D
Petoskey, MI 49770-8774
Phone: (231) 487-1020
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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 number1760008528
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Sheperd — Ceo/President · (231) 487-1020
NPI enumeratedJune 17, 2020
Last updated in NPPESJune 17, 2020
Certification dateJune 17, 2020
Mailing address2325 Summit Park Dr Ste D, Petoskey, MI 49770-8774

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