| Pro Dental Mi 1 Pc | |
|
1124 28th St Sw Wyoming MI 49509-2855 | |
| (616) 530-9900 | |
| (616) 530-9959 |
| Full Name | Pro Dental Mi 1 Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1124 28th St Sw, Wyoming, 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: (848) 326-8840 | Pro Dental Mi 1 Pc 1124 28th St Sw Wyoming MI 49509-2855 Ph: (616) 530-9900 |
| NPI Number | 1326875600 |
|---|---|
| Provider Enumeration Date | 09/19/2024 |
| Last Update Date | 09/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326875600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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