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Organization

SOUTHGATE FAMILY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA CHAMBERLAIN (OFFICE MANAGER)
(734) 324-2000
Entity
Organization

Contact information

Practice address
15185 ALLEN RD, SOUTHGATE, MI 48195-2921
(734) 324-2000
(734) 324-2092
Mailing address
15185 ALLEN RD, SOUTHGATE, MI 48195-2921
(734) 324-2000
(734) 324-2092

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
07/10/2020
Last updated
07/13/2020
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