Organization
SOUTHFIELD GUM DOCS, LLC
Active
Other names
MICHIGAN GUM DOCS
Organization subpart
No
Provider details
NPI number
Authorized official
OLEG UNPRICED KRIVICHKIN DDS (DOCTOR)
(248) 327-1919
Entity
Organization
Contact information
Practice address
18860 W 10 MILE RD, SOUTHFIELD, MI 48075-2666
(248) 327-1919
Mailing address
18860 W 10 MILE RD, SOUTHFIELD, MI 48075-2666
(248) 327-1919
(248) 552-0992
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
21098
MI
Other
Enumeration date
03/20/2018
Last updated
07/22/2020
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