# UNIVERSITY OF DETROIT MERCY

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

## Provider details

- **NPI number:** 1386050664
- **Authorized official:** DR. MARY PARISE DDS (PROGRAM DIRECTOR AEGD)
- **Authorized official phone:** (313) 494-6907

## Contact information

- **Practice address:** 2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
- **Practice address phone:** (313) 993-1000
- **Mailing address:** 2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
- **Mailing address phone:** (313) 993-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901021308 | MI | Yes |

## Other

- **Enumeration date:** 07/07/2014
- **Last updated:** 07/07/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1 | — | MI |