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Organization
DR. ELDIB FORT GRATIOT, PLLC
Active
Organization
DR. ELDIB FORT GRATIOT, PLLC
Active
Other names
New Era Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLEY VARGA (DIRECTOR OF BUSINESS OPERATIONS)
(734) 808-0000
Entity
Organization
Contact information
Practice address
4036 24TH AVE, FORT GRATIOT, MI 48059-3800
(810) 385-9766
(810) 990-8403
Mailing address
4036 24TH AVE, FORT GRATIOT, MI 48059-3800
(810) 385-9766
(810) 990-8403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/21/2024
Last updated
03/24/2025
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