Individual
MATTHEW CANNAVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
7633 E JEFFERSON AVE, SUITE 70, DETROIT, MI 48214-3730
(313) 499-4775
(313) 499-4953
Mailing address
7633 E JEFFERSON AVE, SUITE 70, DETROIT, MI 48214-3730
(313) 499-4775
(313) 499-4953
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901021268
MI
Other
Enumeration date
08/27/2014
Last updated
03/29/2016
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