Individual
MISS TERRI FATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
559 W GRAND BLVD, DETROIT, MI 48216-2200
(313) 554-3880
Mailing address
38372 TIMBERLAND DR, WESTLAND, MI 48185-2688
(734) 207-6297
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902008635
MI
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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