Individual
LORELEI E CLAIBORNE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
5635 W FORT ST, DETROIT, MI 48209-3154
(313) 849-3920
(313) 849-0824
Mailing address
5635 W FORT ST, DETROIT, MI 48209-3154
(313) 849-3920
(313) 849-0824
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
2901015933
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2915665
—
MI
Enumeration date
10/27/2005
Last updated
07/08/2007
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