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Organization
TOTAL DENTAL FITNESS
Active
Organization
TOTAL DENTAL FITNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN DAVID MAYLATH D.D.S. (PRESIDENT)
(248) 642-5020
Entity
Organization
Contact information
Practice address
50 W BIG BEAVER RD, STE 120, BLOOMFIELD HILLS, MI 48304-3910
(248) 642-5020
Mailing address
50 W BIG BEAVER RD, STE 120, BLOOMFIELD HILLS, MI 48304-3910
(248) 642-5020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14767
MI
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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