Organization
SUPREME DENTAL OF PLYMOUTH ROAD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE BLOXSON (PRESIDENT)
(313) 416-6806
Entity
Organization
Contact information
Practice address
20720 PLYMOUTH RD, DETROIT, MI 48228-1275
(313) 342-1997
Mailing address
27201 RYAN RD, WARREN, MI 48092-5127
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003804303
—
MI
Enumeration date
02/03/2014
Last updated
02/03/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us