Organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Active
Parent organization
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Other names
Affordable Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL CARE OF MICHIGAN, P.C.
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
18181 W 12 MILE RD STE 1, LATHRUP VILLAGE, MI 48076-2666
(248) 849-9310
Mailing address
18181 W 12 MILE RD STE 1, LATHRUP VILLAGE, MI 48076-2666
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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