Organization
INDEPENDENCE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER STINES DDS (PRESIDENT)
(517) 223-9753
Entity
Organization
Contact information
Practice address
717 S GRAND AVE, FOWLERVILLE, MI 48836-7914
(517) 223-9753
Mailing address
PO BOX 158, FOWLERVILLE, MI 48836-0158
(517) 223-9753
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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