# BENJAMIN J UNDERWOOD DDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Village Place Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710449459
- **Authorized official:** CARYN MALLON (OFFICE MANAGER)
- **Authorized official phone:** (586) 264-5410

## Contact information

- **Practice address:** 6213 CHICAGO RD STE 100, WARREN, MI 48092-1697
- **Practice address phone:** (586) 264-5410
- **Practice address fax:** (586) 264-1119
- **Mailing address:** 6213 CHICAGO RD STE 100, WARREN, MI 48092-1697
- **Mailing address phone:** (586) 264-5410
- **Mailing address fax:** (586) 264-1119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/02/2019
- **Last updated:** 04/02/2019