Organization
BILA, PPLC
Active
Other names
Total Dental Fitness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTEN M CICCARELLI DDS (OWNER)
(734) 748-9553
Entity
Organization
Contact information
Practice address
50 W BIG BEAVER RD STE 100, BLOOMFIELD HILLS, MI 48304-3910
(248) 642-5020
Mailing address
50 W BIG BEAVER RD STE 100, BLOOMFIELD HILLS, MI 48304-3910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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