Organization
WDW EASTPOINTE PLLC
Active
Parent organization
WDW ROSEVILLE PLLC
Other names
Lakeshore Periodontics and Oral Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
WDW ROSEVILLE PLLC
Authorized official
WHITNEY WEINER (OWNER)
(586) 777-0260
Entity
Organization
Contact information
Practice address
18501 E 8 MILE RD, EASTPOINTE, MI 48021-3200
(586) 777-0260
Mailing address
18501 E 8 MILE RD, EASTPOINTE, MI 48021-3200
(586) 777-0260
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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