| Detalmax Pc | |
|
6655 Alpine Ave Nw Suite 1 Comstock Park MI 49321-8000 | |
| (616) 784-8950 | |
| (616) 784-9553 |
| Full Name | Detalmax Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6655 Alpine Ave Nw, Comstock Park, Michigan |
| Authorized Official Name and Position | Gregory P Houghteling (CEO) |
| Authorized Official Contact | 6167848950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Detalmax Pc 6655 Alpine Ave Nw Suite 1 Comstock Park MI 49321-8000 Ph: (616) 784-8950 | Detalmax Pc 6655 Alpine Ave Nw Suite 1 Comstock Park MI 49321-8000 Ph: (616) 784-8950 |
| NPI Number | 1194084780 |
|---|---|
| Provider Enumeration Date | 05/16/2012 |
| Last Update Date | 05/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194084780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2901011820 (Michigan) | Primary |
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