Individual
JUSTIN DISTELRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1795 W STADIUM BLVD, ANN ARBOR, MI 48103-5290
(734) 677-8700
(734) 839-4137
Mailing address
1795 W STADIUM BLVD, ANN ARBOR, MI 48103-5290
(734) 677-8700
(734) 839-4137
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901023205
MI
Other
Enumeration date
06/27/2019
Last updated
09/12/2022
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