Organization
ADVANCED DENTAL IMAGING OF MICHIGAN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA T VANDEVELDE (OWNER/MANAGER)
(248) 977-1012
Entity
Organization
Contact information
Practice address
10 W SQUARE LAKE RD, SUITE 305, BLOOMFIELD HILLS, MI 48302-0465
(248) 977-1012
Mailing address
10 W SQUARE LAKE RD, SUITE 305, BLOOMFIELD HILLS, MI 48302-0465
(248) 977-1012
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901014174
MI
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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