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Organization
THE DENTAL CLINIC PC
Active
Organization
THE DENTAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS MICHAEL COLLINS DDS (PRESIDENT)
(313) 386-9660
Entity
Organization
Contact information
Practice address
1359 CHAMPAIGN, LINCOLN PARK, MI 48146-3303
(313) 386-9660
(313) 386-5515
Mailing address
1359 CHAMPAIGN, LINCOLN PARK, MI 48146-3303
(313) 386-9660
(313) 386-5515
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1958213740
BLUE CROSS MEDICAL
MI
Enumeration date
08/17/2006
Last updated
08/22/2020
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