Organization
GD MI RIVERVIEW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIAING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
17128 FORT ST, RIVERVIEW, MI 48193-6619
(734) 281-3200
Mailing address
17128 FORT ST, RIVERVIEW, MI 48193-6619
(734) 281-3200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/28/2022
Last updated
02/28/2022
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