Organization
SOUTHFIELD KIDS DENTIST PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IFECHIDE NWABUEZE DMD (MANAGER)
(248) 217-7997
Entity
Organization
Contact information
Practice address
18900 W 10 MILE RD, SOUTHFIELD, MI 48075-2669
(248) 565-3332
Mailing address
18900 W 10 MILE RD, SOUTHFIELD, MI 48075-2669
(248) 565-3332
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2901020260
MI
Other
Enumeration date
09/22/2016
Last updated
01/20/2022
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