Individual
MEGAN WIDTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
43050 FORD RD STE 190, CANTON, MI 48187-3359
(734) 667-5475
Mailing address
3950 S SHORE DR, COMMERCE TOWNSHIP, MI 48382-4397
(248) 410-4562
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600675
MI
Other
Enumeration date
08/31/2020
Last updated
09/10/2020
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