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Organization

DETROIT DENTAL SPA PLLC

Active
Other names
Detroit Dental Spa
Organization subpart
No

Provider details

NPI number
Authorized official
BAN NACY DDS (OWNER/DENTIST)
(832) 419-7998
Entity
Organization

Contact information

Practice address
2130 TRUMBULL ST, DETROIT, MI 48216-1344
(832) 419-7998
Mailing address
1117 GRISWOLD ST UNIT 1414, DETROIT, MI 48226-1936
(832) 419-7998

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
01/05/2023
Last updated
03/15/2023
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