Organization
A1 FAMILY DENTISTRY OF LICOLN PARK,PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANEEL KAURR RANDHAWA DDS (OWNER)
(586) 226-0638
Entity
Organization
Contact information
Practice address
3830 FORT ST, LINCOLN PARK, MI 48146-4107
(586) 226-0638
Mailing address
50481 KOSS DR, MACOMB, MI 48044-6320
(586) 226-0638
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901019199
MI
Other
Enumeration date
07/10/2015
Last updated
07/10/2015
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