Individual
THOMAS CHAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
27115 GRATIOT AVE, ROSEVILLE, MI 48066-2900
(586) 774-3520
Mailing address
300 E LONG LAKE RD, BLOOMFIELD HILLS, MI 48304-2374
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901021658
MI
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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