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Organization
PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN, LLC
Active
Organization
PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN, LLC
Active
Other names
Refresh Dental Center Line
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JONES (CREDENTIALING SPECIALIST)
(724) 698-2132
Entity
Organization
Contact information
Practice address
23845 VAN DYKE AVE, CENTER LINE, MI 48015-1300
(586) 467-0063
Mailing address
11 S MILL ST, SUITE 200, NEW CASTLE, PA 16101-3613
(724) 698-2500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/03/2017
Last updated
03/13/2017
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