# FILL GOOD DENTAL CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093266215
- **Authorized official:** LAWRENCE STEWART D.D.S. (DOC/PARTNER)
- **Authorized official phone:** (313) 837-3000

## Contact information

- **Practice address:** 18570 GRAND RIVER AVE, 102, DETROIT, MI 48223-2201
- **Practice address phone:** (313) 837-3000
- **Practice address fax:** (313) 838-4581
- **Mailing address:** 18750 GRAND RIVER AVE, 102, DETROIT, MI 48223
- **Mailing address phone:** (313) 837-3000
- **Mailing address fax:** (313) 838-4581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901017708 | MI | Yes |

## Other

- **Enumeration date:** 10/24/2016
- **Last updated:** 10/24/2016