Organization
FAIRCOURT DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN VITALE (OFFICE MANAGER)
(313) 882-2000
Entity
Organization
Contact information
Practice address
20040 MACK AVE, GROSSE POINTE WOODS, MI 48236-2360
(313) 882-2000
(313) 882-2515
Mailing address
20040 MACK AVE, GROSSE POINTE WOODS, MI 48236-2360
(313) 882-2000
(313) 882-2515
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/22/2019
Last updated
01/28/2020
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