| David K. Vazquez D.d.s. Plc | |
|
1150 Mason St Dearborn MI 48124-2801 | |
| (313) 429-1005 | |
| (313) 429-1008 |
| Full Name | David K. Vazquez D.d.s. Plc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1150 Mason St, Dearborn, Michigan |
| Authorized Official Name and Position | David K. Vazquez (OWNER) |
| Authorized Official Contact | 3134291005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David K. Vazquez D.d.s. Plc 1150 Mason St Dearborn MI 48124-2801 Ph: (313) 429-1005 | David K. Vazquez D.d.s. Plc 1150 Mason St Dearborn MI 48124-2801 Ph: (313) 429-1005 |
| NPI Number | 1821614876 |
|---|---|
| Provider Enumeration Date | 06/24/2020 |
| Last Update Date | 06/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821614876 | NPI | - | NPPES |
| 1487905998 | Medicaid | MI | |
| 1043749492 | Medicaid | MI | |
| 1154701969 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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