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Organization
SUPER DENTAL OF LIVERNOIS AVE, PC
Active
Organization
SUPER DENTAL OF LIVERNOIS AVE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA HYDE 2484181021 (OFFICE MANAGER)
(248) 418-1021
Entity
Organization
Contact information
Practice address
15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
(313) 863-2800
Mailing address
15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
(313) 863-2800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/03/2013
Last updated
07/03/2013
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