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Organization

DPN-MI PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DOMINICK LAGO JR. MD (OWNER)
(530) 350-0889
Entity
Organization

Contact information

Practice address
29877 TELEGRAPH RD STE L-12, SOUTHFIELD, MI 48034-7657
(657) 439-4455
(248) 226-5827
Mailing address
29877 TELEGRAPH RD STE LL-12, SOUTHFIELD, MI 48034-1332
(248) 213-6222
(248) 226-5827

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
05/25/2021
Last updated
06/11/2021
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