Organization
WEST GRAND DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DELORES CAMPBELL (MANAGER)
(313) 407-6291
Entity
Organization
Contact information
Practice address
2617 W GRAND BLVD, DETROIT, MI 48208-1234
(313) 875-3440
(313) 875-0521
Mailing address
2617 W GRAND BLVD, DETROIT, MI 48208-1234
(313) 875-3440
(313) 875-0521
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15814
MI
Other
Enumeration date
02/18/2009
Last updated
02/18/2009
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