Individual
CLARISSA SOUZA GOMES DA FONTOURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-3042
Mailing address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-3042
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2952000723
MI
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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