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Organization
DOCSMILE DENTAL CENTER
Active
Organization
DOCSMILE DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACEY E JOHNSON-ROBINSON (ADMINISTRATOR)
(800) 362-7645
Entity
Organization
Contact information
Practice address
18601 MACK AVE, GROSSE POINTE, MI 48236-3250
(800) 362-7645
Mailing address
PO BOX 1082, DEARBORN, MI 48121-1082
(800) 362-7645
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
2901011576
MI
292200000X
Dental Laboratory
2901015328
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2737563
—
MI
05
—
4490053
—
MI
Enumeration date
05/02/2007
Last updated
10/07/2010
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