# MIDWESTERN DENTAL OF DETROIT

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

## Provider details

- **NPI number:** 1760431936
- **Authorized official:** JOHN MORGAN JR. (ADMINISTRATIVE DIRECTOR)
- **Authorized official phone:** (313) 582-8150

## Contact information

- **Practice address:** 1415 TRUMBULL ST, DETROIT, MI 48216-1368
- **Practice address phone:** (313) 963-2222
- **Practice address fax:** (313) 963-3665
- **Mailing address:** 5050 SCHAEFER RD, DEARBORN, MI 48126-3249
- **Mailing address phone:** (313) 582-8150
- **Mailing address fax:** (313) 582-6015

## Taxonomy

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

## Other

- **Enumeration date:** 05/08/2006
- **Last updated:** 08/22/2020