Organization
CREATIVE DENTAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A KOHN D.D.S. (OWNER)
(586) 751-6617
Entity
Organization
Contact information
Practice address
28225 HOOVER RD, WARREN, MI 48093-5436
(586) 751-6617
(586) 751-6264
Mailing address
28225 HOOVER RD, WARREN, MI 48093-5436
(586) 751-6617
(586) 751-6264
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015192
MI
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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