Individual
DR. ERIC W PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
519 W MAIN ST, MILAN, MI 48160-9559
(734) 439-1543
(734) 439-0553
Mailing address
519 W MAIN ST, P.O. BOX 16, MILAN, MI 48160-9559
(734) 439-1543
(734) 439-0553
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16900
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110788
AETNA DMO
MI
05
—
4135430
—
MI
Enumeration date
01/26/2007
Last updated
07/08/2007
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