Individual
BENJAMIN UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6213 CHICAGO RD, 100, WARREN, MI 48092-1697
(586) 264-5410
Mailing address
675 WORTHINGTON RD, CANTON, MI 48188-1561
(734) 306-6061
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021514
MI
Other
Enumeration date
05/30/2015
Last updated
05/30/2015
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