Organization
RENAISSANCE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALLACE L WALKER JR. DDS (DENTIST)
(313) 340-9293
Entity
Organization
Contact information
Practice address
7330 W WARREN AVE, DETROIT, MI 48210-1041
(313) 340-9293
(313) 340-9293
Mailing address
7330 W WARREN AVE, DETROIT, MI 48210-1041
(313) 340-9293
(313) 340-9293
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12881
MI
Other
Enumeration date
06/13/2007
Last updated
08/22/2020
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