# DENTAL CHOICE MOBILE DENTISTRY, PLLC

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

## Provider details

- **NPI number:** 1700207669
- **Authorized official:** GLORIA JOHNSON (MANAGER)
- **Authorized official phone:** (313) 790-0094

## Contact information

- **Practice address:** 634 PRINCESS DR, CANTON, MI 48188-1144
- **Practice address phone:** (734) 788-8061
- **Mailing address:** PO BOX 37047, OAK PARK, MI 48237-0047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901011776 | MI | Yes |

## Other

- **Enumeration date:** 12/19/2013
- **Last updated:** 12/19/2013