Individual
KE'ALE W LOUIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3060 BAKER RD, DEXTER, MI 48130-1140
(734) 426-4651
Mailing address
1741 COBURN CT, ANN ARBOR, MI 48108-8902
(818) 917-8986
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600793
MI
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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