| Professional Dental Alliance Of Michigan, Llc | |
|
23845 Van Dyke Ave Center Line MI 48015-1300 | |
| (586) 467-0063 | |
| Not Available |
| Full Name | Professional Dental Alliance Of Michigan, Llc |
|---|---|
| Speciality | Dentist |
| Location | 23845 Van Dyke Ave, Center Line, Michigan |
| Authorized Official Name and Position | Maria Jones (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7246982132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Of Michigan, Llc 11 S Mill St Suite 200 New Castle PA 16101-3613 Ph: (724) 698-2500 | Professional Dental Alliance Of Michigan, Llc 23845 Van Dyke Ave Center Line MI 48015-1300 Ph: (586) 467-0063 |
| NPI Number | 1942740337 |
|---|---|
| Provider Enumeration Date | 03/03/2017 |
| Last Update Date | 03/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942740337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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