Organization
BAUM DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MARIE KIRCHNER REDENTIALING MANAGER (CREDENTIALING MANAGER)
(586) 873-4483
Entity
Organization
Contact information
Practice address
20720 PLYMOUTH RD, DETROIT, MI 48228-1275
(313) 342-1997
(313) 416-1405
Mailing address
20720 PLYMOUTH RD, DETROIT, MI 48228-1275
(313) 342-1997
(313) 416-1405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901010299
MI
Other
Enumeration date
04/01/2013
Last updated
06/23/2017
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