Organization
DELUXE DENTAL ASSOCIATES #12- SHELBY, PLLC
Active
Other names
Deluxe Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTI LYNN LOONEY (BILLER/CREDENTIALER)
(810) 787-6332
Entity
Organization
Contact information
Practice address
56625 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-5025
(586) 248-4500
(810) 243-0454
Mailing address
56625 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-5025
(586) 248-4500
(810) 243-0454
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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