Organization
CONVENIENT BR PC
Active
Other names
Distinctive Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE R MASCHKE (ASST. TO GEN. MGR)
(248) 542-9700
Entity
Organization
Contact information
Practice address
2120 GRAND RIVER ANX, SUITE 100, BRIGHTON, MI 48114-7392
(810) 225-0022
(810) 225-0033
Mailing address
2120 GRAND RIVER ANX, SUITE 100, BRIGHTON, MI 48114-7392
(810) 225-0022
(810) 225-0033
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019426
MI
Other
Enumeration date
11/07/2013
Last updated
12/12/2014
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