Individual
MISS STAVIT MEASOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6161 ORCHARD LAKE RD, WEST BLOOMFIELD, MI 48322-2384
(248) 851-4115
Mailing address
6161 ORCHARD LAKE RD, WEST BLOOMFIELD, MI 48322-2384
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901016470
MI
Other
Enumeration date
01/11/2016
Last updated
01/11/2016
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