Organization
ELAN OKEMOS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGIO MAURICIO MOELLER DDS (DENTIST/ OWNER)
(734) 276-2541
Entity
Organization
Contact information
Practice address
2445 WOODLAKE CIR, OKEMOS, MI 48864-5941
(734) 662-7874
Mailing address
2509 S STATE ST, ANN ARBOR, MI 48104-6145
(734) 662-7874
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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