Organization
WUNDERLICH & CHANG DDS, MS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD C WUNDERLILCH DDS, MS (PRESIDENT)
(734) 981-7474
Entity
Organization
Contact information
Practice address
42301 CHERRY HILL RD, SUITE A, CANTON, MI 48188-9801
(734) 981-7477
(734) 981-0328
Mailing address
42301 CHERRY HILL RD, SUITE A, CANTON, MI 48188-9801
(734) 981-7477
(734) 981-0328
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J800274
BLUE CROSS BLUE SHIELD
MI
Enumeration date
09/24/2008
Last updated
09/24/2008
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