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Organization

GENERAL DENTISTRY SPECIALISTS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DONNA MARIE KIRCHNER (CREDENTIALING MANAGER)
(586) 915-0107
Entity
Organization

Contact information

Practice address
15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
(313) 863-2800
(313) 341-7867
Mailing address
15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
(313) 863-2800
(313) 341-7867

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901018508
MI

Other

Enumeration date
11/25/2014
Last updated
11/25/2014
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