Individual
DR. LUCA TEDESCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
430 WILEY RD, DOUGLAS, MI 49406-5122
(269) 857-1431
Mailing address
3725 KAYLEE LN, HUDSONVILLE, MI 49426-8464
(313) 979-0334
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600141
MI
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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