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Organization
GREAT LAKES DENTAL SERVICES PLLC
Active
Organization
GREAT LAKES DENTAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUDOLPH DELANO WHEATON DDS (DIRECTOR)
(810) 308-5086
Entity
Organization
Contact information
Practice address
5621 LESLIE CT, FLINT, MI 48504
(810) 308-5086
Mailing address
5621 LESLIE CT, FLINT, MI 48504
(810) 308-5086
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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