Organization
SUPER DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA A LOREDO DDS (DIRECTOR)
(313) 863-2800
Entity
Organization
Contact information
Practice address
15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
(313) 863-2800
Mailing address
PO BOX 38367, DETROIT, MI 48238
(313) 863-2800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/24/2008
Last updated
09/24/2008
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