Organization
D2 DENTAL OF MICHIGAN, P.C.
Active
Other names
Destiny Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BORIS LABINOV (AGENT)
(708) 613-4542
Entity
Organization
Contact information
Practice address
14736 MACK AVE, DETROIT, MI 48215-2524
(313) 412-2100
Mailing address
137 N OAK PARK AVE STE 310, OAK PARK, IL 60301-1339
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/08/2017
Last updated
07/08/2017
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