Individual
ROBERT VANCE ANTOLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15055 22 MILE RD, SUITE #2, SHELBY TOWNSHIP, MI 48315-4401
(586) 247-3500
(586) 247-1211
Mailing address
15055 22 MILE RD, SUITE #2, SHELBY TOWNSHIP, MI 48315-4401
(586) 247-3500
(586) 247-1211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14690
MI
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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