Organization
CODY DENTAL CENTER P.C.
Active
Other names
Dr. Karen E. Eggleston
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN E. EGGLESTON D.D.S. (OWNER)
(248) 395-4700
Entity
Organization
Contact information
Practice address
17070 W 12 MILE RD, SUITE C, SOUTHFIELD, MI 48076-2116
(248) 395-4700
Mailing address
17070 W 12 MILE RD, SUITE C, SOUTHFIELD, MI 48076-2116
(248) 395-4700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13102
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J131020
BLUE CROSS BLUE SHIELD
MI
Enumeration date
01/15/2007
Last updated
04/24/2008
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