Organization
PARK DENTAL SERVICE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SMITH DDS (OWNER)
(313) 835-8280
Entity
Organization
Contact information
Practice address
18935 GRAND RIVER AVE, DETROIT, MI 48223-2273
(313) 835-8280
(313) 835-2879
Mailing address
18935 GRAND RIVER AVE, DETROIT, MI 48223-2273
(313) 835-8280
(313) 835-2879
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
13515
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1929970
—
MI
Enumeration date
08/25/2016
Last updated
08/25/2016
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