# GD MI PLLC

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

## Provider details

- **NPI number:** 1609411560
- **Authorized official:** FRED WEINBERG (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (412) 849-3919

## Contact information

- **Practice address:** 24033 MEADOWBROOK RD, NOVI, MI 48375-3456
- **Practice address phone:** (248) 305-1689
- **Mailing address:** 22610 SHEVINGTON DR, SOUTHFIELD, MI 48034-6213
- **Mailing address phone:** (412) 849-3919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/14/2019
- **Last updated:** 11/14/2019