Organization
GRASS LAKE DENTAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUCIANA GABRIELA CASTRO DDS (OWNER)
(734) 355-0779
Entity
Organization
Contact information
Practice address
11745 E MICHIGAN AVE, GRASS LAKE, MI 49240-9219
(517) 522-5018
Mailing address
2143 ORCHARDVIEW, ANN ARBOR, MI 48108-2766
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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