Organization
EAGAN ORTHODONTICS PC
Active
Other names
Eagan Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOY VICTOR EAGAN DDS (OWNER)
(248) 569-8770
Entity
Organization
Contact information
Practice address
17600 W 12 MILE ROAD, SUITE 4, SOUTHFIELD, MI 48076-1910
(248) 569-8770
(248) 569-2476
Mailing address
17600 W 12 MILE ROAD, SUITE 4, SOUTHFIELD, MI 48076-1910
(248) 569-8770
(248) 569-2476
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13440
MI
Other
Enumeration date
01/30/2007
Last updated
08/22/2020
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