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Organization
SOUTHFIELD GUM DOCS, LLC
Active
Organization
SOUTHFIELD GUM DOCS, LLC
Active
Other names
MICHIGAN GUM DOCS
Organization subpart
No
Provider details
NPI number
Authorized official
OLEG UNPRICED KRIVICHKIN DDS (DOCTOR)
(248) 327-1919
Entity
Organization
Contact information
Practice address
18860 W 10 MILE RD, SOUTHFIELD, MI 48075-2666
(248) 327-1919
Mailing address
18860 W 10 MILE RD, SOUTHFIELD, MI 48075-2666
(248) 327-1919
(248) 552-0992
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
21098
MI
Other
Enumeration date
03/20/2018
Last updated
07/22/2020
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