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Organization

GROWING SMILES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JULIE M SPINEK (GENERAL MANAGER)
(586) 727-5500
Entity
Organization

Contact information

Practice address
36602 HERITAGE DR, RICHMOND, MI 48062
(586) 727-5500
(586) 727-3950
Mailing address
51821 GRATIOT AVE., CHESTERFIELD, MI 48051
(586) 727-5500
(586) 727-3950

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2901020657
MI
1223P0300X
Periodontics
2901021820
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1083857783
PEDIATRIC DENTIST
MI
01
1588911788
PEDIATRIC DENTIST
MI
Enumeration date
06/23/2016
Last updated
06/23/2016
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