Individual
CAROL BALAN MOYNIHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
35 MAIN ST STE 102, BELLEVILLE, MI 48111-3287
(734) 697-3011
(734) 697-3779
Mailing address
14403 BARBARA ST, LIVONIA, MI 48154-5348
(734) 864-8729
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901015646
MI
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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