Organization
CHILDRENS DENTAL PROGRAM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IFECHIDE NWABUEZR DMD (OWNER)
(248) 217-7997
Entity
Organization
Contact information
Practice address
22241 JOHN R RD, HAZEL PARK, MI 48030-1716
(248) 217-7997
Mailing address
22241 JOHN R RD, HAZEL PARK, MI 48030-1716
(248) 217-7997
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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