Individual
OBADA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2850 US HIGHWAY 41 W, MARQUETTE, MI 49855-2253
(906) 629-1369
Mailing address
27056 NORTHMORE ST, DEARBORN HEIGHTS, MI 48127-3644
(313) 471-0820
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901601713
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2023
Last updated
06/01/2023
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