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Organization
GREAT LAKES DENTAL GROUP PLLC
Active
Organization
GREAT LAKES DENTAL GROUP PLLC
Active
Other names
Dental Implant Center of Royal Oak
Organization subpart
No
Provider details
NPI number
Authorized official
DELIA DANOWSKI (OFFICE MANAGER)
(248) 547-3700
Entity
Organization
Contact information
Practice address
4251 COOLIDGE HWY, ROYAL OAK, MI 48073-1639
(248) 547-3700
Mailing address
4251 COOLIDGE HWY, ROYAL OAK, MI 48073-1639
(248) 547-3700
(248) 547-2297
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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