Organization
POINTE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL S VAN WALLEGHEM DDS (OWNER)
(313) 886-9201
Entity
Organization
Contact information
Practice address
18342 MACK AVE, GROSSE POINTE FARMS, MI 48236-3219
(313) 886-9201
Mailing address
18342 MACK AVE, GROSSE POINTE FARMS, MI 48236-3219
(313) 886-9201
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
BV0626397
MI
Other
Enumeration date
08/27/2009
Last updated
08/27/2009
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