Individual
RITA MAIZY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2792 PACKARD RD, YPSILANTI, MI 48197-1932
(734) 645-6548
Mailing address
9266 NORTHERN AVE, PLYMOUTH, MI 48170-4046
(248) 854-4638
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901600493
MI
122300000X
Dentist
2901600493APP20
MI
1223G0001X
General Practice Dentistry
Primary
2901600493
MI
1223G0001X
General Practice Dentistry
2901600493APP20
MI
Other
Enumeration date
04/24/2020
Last updated
11/30/2021
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