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Organization
SUPERIOR FAMILY DENTAL
Active
Organization
SUPERIOR FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY FREIJ D.D.S. (PARTNER)
(734) 474-4703
Entity
Organization
Contact information
Practice address
31393 W 13 MILE RD, SUITE 100, FARMINGTON HILLS, MI 48334-2297
(734) 474-4703
Mailing address
31393 W 13 MILE RD, SUITE 100, FARMINGTON HILLS, MI 48334-2297
(734) 474-4703
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901018929
GENERAL DENTIST
MI
01
—
2901019344
DENTIST GENERAL PRACTICE
MI
Enumeration date
03/12/2009
Last updated
03/12/2009
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