Organization
PEDIATRIC DENTAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY A STERN DDS (DENTIST)
(734) 425-0600
Entity
Organization
Contact information
Practice address
31560 SCHOOLCRAFT RD, LIVONIA, MI 48150-1805
(734) 425-0600
Mailing address
31560 SCHOOLCRAFT RD, LIVONIA, MI 48150-1805
(734) 425-0600
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2901009379
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4292191
—
MI
Enumeration date
03/17/2008
Last updated
03/17/2008
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