Organization
GREAT LAKES ORAL SURGERY PLLC
Active
Other names
Wisdom Tooth & Dental Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA ALLEN DEUEL DDS (OWNER/OPERATOR)
(269) 845-0671
Entity
Organization
Contact information
Practice address
955 W EISENHOWER CIR STE G, ANN ARBOR, MI 48103-5868
(269) 845-0671
Mailing address
2265 S MAIN ST, ANN ARBOR, MI 48103-5830
(269) 845-0671
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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