Organization
FILL GOOD DENTAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE STEWART D.D.S. (DOC/PARTNER)
(313) 837-3000
Entity
Organization
Contact information
Practice address
18570 GRAND RIVER AVE, 102, DETROIT, MI 48223-2201
(313) 837-3000
(313) 838-4581
Mailing address
18750 GRAND RIVER AVE, 102, DETROIT, MI 48223
(313) 837-3000
(313) 838-4581
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901017708
MI
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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