Organization
MICHIGAN DENTUREAND IMPLANT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE J VERNIER DDS (DENTIST)
(313) 592-1100
Entity
Organization
Contact information
Practice address
26001 GRAND RIVER AVE, REDFORD, MI 48240-1440
(313) 592-1100
(313) 592-0061
Mailing address
26001 GRAND RIVER AVE, REDFORD, MI 48240-1440
(313) 592-1100
(313) 592-0061
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14476
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802855
BLUE CROSS BLUE SHIELD
MI
01
—
818900
UNITED CONCORDIA
MI
01
—
838921
UNITED CONCORDIA
MI
Enumeration date
05/23/2007
Last updated
08/22/2020
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