Individual
MISS ELIZABETH ANNE VANTUBERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
21800 PONTIAC TRAIL, STE 100, SOUTH LYON, MI 48178
(248) 437-8300
(248) 437-8066
Mailing address
21800 PONTIAC TRAIL, STE 100, SOUTH LYON, MI 48178
(248) 437-8300
(248) 437-8066
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019921
MI
Other
Enumeration date
05/05/2009
Last updated
05/05/2009
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