| Cody Dental Center P.c. | |
|
17070 W 12 Mile Rd Suite C Southfield MI 48076-2116 | |
| (248) 395-4700 | |
| Not Available |
| Full Name | Cody Dental Center P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17070 W 12 Mile Rd, Southfield, Michigan |
| Authorized Official Name and Position | Karen E. Eggleston (OWNER) |
| Authorized Official Contact | 2483954700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cody Dental Center P.c. 17070 W 12 Mile Rd Suite C Southfield MI 48076-2116 Ph: (248) 395-4700 | Cody Dental Center P.c. 17070 W 12 Mile Rd Suite C Southfield MI 48076-2116 Ph: (248) 395-4700 |
| NPI Number | 1255482659 |
|---|---|
| Provider Enumeration Date | 01/15/2007 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255482659 | NPI | - | NPPES |
| J131020 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13102 (Michigan) | Primary |
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