Organization
FOREVER YOUNG DENTISTRY BAYSIDE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MARSHALL (FINANCIAL COORDINATOR)
(586) 795-5678
Entity
Organization
Contact information
Practice address
36555 26 MILE RD STE 3900, LENOX, MI 48048-3190
(586) 277-0080
Mailing address
39242 DEQUINDRE RD STE 106, STERLING HEIGHTS, MI 48310-1767
(586) 795-5678
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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