Individual
MICHAEL S SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
49114 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48317-1332
(586) 884-6380
Mailing address
11 S MILL ST STE 200, NEW CASTLE, PA 16101-3680
(724) 698-2132
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600168
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901600168
STATE LICENSE
MI
Enumeration date
07/10/2019
Last updated
07/10/2019
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