# CENTERLINE DENTURE CLINIC

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

## Provider details

- **NPI number:** 1598920597
- **Authorized official:** RAY ELLIOTT (OFFICE MANAGER)
- **Authorized official phone:** (586) 756-5880

## Contact information

- **Practice address:** 24625 VAN DYKE AVE, CENTER LINE, MI 48015-2303
- **Practice address phone:** (586) 756-5880
- **Mailing address:** 24625 VAN DYKE AVE, CENTER LINE, MI 48015-2303
- **Mailing address phone:** (586) 756-5880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4963 | MI | Yes |

## Other

- **Enumeration date:** 07/20/2008
- **Last updated:** 07/20/2008