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Organization
PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN,LLC
Active
Organization
PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN,LLC
Active
Other names
Refresh Dental Warren - E. 12 Mile Rd
Organization subpart
No
Provider details
NPI number
Authorized official
SHAMS HAMAMA (REGIONAL MANAGER)
(586) 573-7500
Entity
Organization
Contact information
Practice address
11552 E 12 MILE RD, WARREN, MI 48093-2644
(586) 573-7500
Mailing address
11 S MILL ST, STE 200, NEW CASTLE, PA 16101-3613
(724) 698-2500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/31/2012
Last updated
04/19/2018
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