Individual
DR. STACEY HANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6610
Mailing address
45607 ELMWOOD CIR, CANTON, MI 48188-2468
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901016075
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901016075
STATE LICENSE
MI
Enumeration date
04/06/2007
Last updated
04/29/2025
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