Organization
GREAT LAKES FAMILY DENTAL GROUP-WARREN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA J. HART (CORPORATE MANAGER)
(810) 625-2860
Entity
Organization
Contact information
Practice address
21635 RYAN RD, WARREN, MI 48091-2788
(810) 230-2345
(810) 230-3229
Mailing address
G3222 BEECHER RD, FLINT, MI 48532-3614
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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