Organization
ORCHARD-TWELVE DENTAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY J BANKS CDA, RDA (OFFICE MANAGER)
(248) 865-0065
Entity
Organization
Contact information
Practice address
27970 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48334-3767
(248) 865-0065
(248) 865-7898
Mailing address
27970 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48334-3767
(248) 865-0065
(248) 865-7898
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17467
MI
Other
Enumeration date
04/28/2008
Last updated
07/29/2008
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