Organization
PRIME DENTISTRY LINCOLN PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA TOMES (OPERATIONS DIRECTOR)
(734) 722-1617
Entity
Organization
Contact information
Practice address
1880 EMMONS BLVD, LINCOLN PARK, MI 48146-3866
(313) 388-8444
Mailing address
24505 FAIRMOUNT DR, DEARBORN, MI 48124-1541
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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