| Pro Dental Mi 1 Pc | |
|
14736 Mack Ave Detroit MI 48215-2524 | |
| (313) 412-2100 | |
| (313) 766-7734 |
| Full Name | Pro Dental Mi 1 Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 14736 Mack Ave, Detroit, Michigan |
| Authorized Official Name and Position | Simone Wilson-adeleke (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 7327318398 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro Dental Mi 1 Pc 10 Woodbridge Center Dr Ste 520 Woodbridge NJ 07095-1152 Ph: (732) 731-8398 | Pro Dental Mi 1 Pc 14736 Mack Ave Detroit MI 48215-2524 Ph: (313) 412-2100 |
| NPI Number | 1912734286 |
|---|---|
| Provider Enumeration Date | 09/19/2024 |
| Last Update Date | 09/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912734286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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