Organization
GD MI SOUTHFIELD PLLC
Active
Other names
Southfield Family Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(248) 569-6304
Entity
Organization
Contact information
Practice address
18800 W 10 MILE RD, SOUTHFIELD, MI 48075-2654
(248) 569-6304
Mailing address
18800 W 10 MILE RD, SOUTHFIELD, MI 48075-2654
(248) 569-6304
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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