Organization
COMPREHENSIVE DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MARIE KIRCHNER (CREDENTIALING MANAGER)
(586) 915-0107
Entity
Organization
Contact information
Practice address
15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
(313) 863-2800
Mailing address
15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
(313) 863-2800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021770
MI
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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