Organization
WELLSPRING DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA R OTTAWAY DDS (DENTIST/OWNER)
(313) 886-9355
Entity
Organization
Contact information
Practice address
20136 MACK AVE, GROSSE POINTE WOODS, MI 48236-1820
(313) 886-9355
(313) 647-9356
Mailing address
20136 MACK AVE, GROSSE POINTE WOODS, MI 48236-1820
(313) 886-9355
(313) 647-9356
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
016554
MI
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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