Dr. Gerald T Licari is a Lake Odessa, Michigan based Dentist who is specialized in
Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Gerald T Licari is
2901011834 for Dentistry in Michigan. His current practice location is
1032 4th Ave, Lake Odessa. Patients can reach him at
616-374-8828.
Dr. Gerald T Licari is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Gerald T Licari speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Dr. Gerald T Licari |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DDS |
| Accepts Medicare Assignment: | No |
| Practice Address: | 1032 4th Ave, Lake Odessa,
Michigan, 48849-1004 |
| Phone: | 616-374-8828 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1376630327 |
| NPI Enumeration Date: | 09 Oct, 2006 |
| NPI Last Update On: | 08 Jul, 2007 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Gerald T Licari are as mentioned below.
| License Number | Specialization | State | Status | |
| 2901011834 | Dentistry | Michigan | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Gerald T Licari such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 11834 | Other | Michigan | BLUE CROSS BLUE SHEILD |
| 4057629 | Medicaid | Michigan | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1032 4th Ave,
Lake Odessa, Michigan |
| Zip: | 48849-1004 |
| Phone Number: | 616-374-8828 |
Patients can reach Dr. Gerald T Licari at
1032 4th Ave, Lake Odessa, Michigan or can
call to book an appointment on 616-374-8828.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.