Organization
EASTLAND DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIANFRANCO TIBERIA DDS (OWNER)
(313) 521-2070
Entity
Organization
Contact information
Practice address
18000 VERNIER, HARPER WOODS, MI 48225
(313) 521-2070
(313) 526-9907
Mailing address
18000 VERNIER, HARPER WOODS, MI 48225
(313) 521-2070
(313) 526-9907
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17767
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4274738
—
MI
Enumeration date
12/11/2006
Last updated
08/22/2020
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