Organization
EAST LANSING ADVANCED DENTAL DBA EAST LANSING MODERN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY S ACOSTA (PRACTICE DEVELOPMENT MANAGER)
(734) 525-6100
Entity
Organization
Contact information
Practice address
2035 ASHER CT, EAST LANSING, MI 48823-8480
(517) 394-1495
Mailing address
2035 ASHER CT, EAST LANSING, MI 48823-8480
(517) 394-1495
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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