Individual
JONATTAN EDUARDO ANGULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11900 E 12 MILE RD STE 210, WARREN, MI 48093-3490
(586) 582-7100
(586) 582-6147
Mailing address
11900 E 12 MILE RD STE 210, WARREN, MI 48093-3490
(586) 582-7100
(586) 582-6147
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2952000716
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
5315214665
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
5315214666
MI
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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