Organization
DENTAL CHOICE MOBILE DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA JOHNSON (MANAGER)
(313) 790-0094
Entity
Organization
Contact information
Practice address
634 PRINCESS DR, CANTON, MI 48188-1144
(734) 788-8061
Mailing address
PO BOX 37047, OAK PARK, MI 48237-0047
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901011776
MI
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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