Individual
MR. MARCUS ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.D.H.
Contact information
Practice address
33060 NORTHWESTERN HWY, SUITE 200, WEST BLOOMFIELD, MI 48322-3693
(313) 444-0778
Mailing address
5334 W MOUNT HOPE HWY, LANSING, MI 48917-9563
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902013398
MI
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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