Organization
DETROIT RECEIVING HOSPITAL AND UNIVERSITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA LARKINS (VICE PRESIDENT OF MICHIGAN)
(313) 745-2117
Entity
Organization
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-4622
Mailing address
PO BOX 67000 DEPT 614150, DETROIT, MI 48267-4150
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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