Organization
DR. ELDIB FORT GRATIOT, PLLC
Active
Other names
New Era Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLEY VARGA (DIRECTOR OF BUSINESS OPERATIONS)
(734) 808-0000
Entity
Organization
Contact information
Practice address
4036 24TH AVE, FORT GRATIOT, MI 48059-3800
(810) 385-9766
(810) 990-8403
Mailing address
4036 24TH AVE, FORT GRATIOT, MI 48059-3800
(810) 385-9766
(810) 990-8403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/21/2024
Last updated
03/24/2025
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