Organization
GANTZ, D.D.S., P.L.L.C.
Active
Other names
elaine Gantz, D.D.S.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELAINE K GANTZ DDS (OWNER)
(248) 353-4010
Entity
Organization
Contact information
Practice address
25865 W 12 MILE RD, SUITE D-112, SOUTHFIELD, MI 48034-1817
(248) 353-4010
(248) 353-0829
Mailing address
25865 W 12 MILE RD, SUITE D-112, SOUTHFIELD, MI 48034-1817
(248) 353-4010
(248) 353-0829
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13299
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013996537
NPI
MI
01
—
1598979676
NPI
MI
Enumeration date
03/11/2008
Last updated
03/11/2008
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