Organization
SUPER DENTAL OF PLYMOUTH ROAD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA HYDE 2484181021 (OFFICE MANAGER)
(248) 418-1021
Entity
Organization
Contact information
Practice address
15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
(313) 863-2800
Mailing address
15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
(313) 863-2800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/03/2013
Last updated
07/03/2013
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