Organization
GD MI MGD PLLC
Active
Other names
Michigan Gum Docs
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
18860 W 10 MILE RD, SOUTHFIELD, MI 48075-2666
(248) 327-1919
Mailing address
18860 W 10 MILE RD, SOUTHFIELD, MI 48075-2666
(248) 327-1919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/20/2022
Last updated
05/20/2022
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