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Organization

DETROIT - GRAND RIVER P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIKE COLE (INSURANCE DIRECTOR)
(727) 726-1611
Entity
Organization

Contact information

Practice address
9685 GRAND RIVER AVE, DETROIT, MI 48204-2139
(313) 834-4900
Mailing address
9685 GRAND RIVER AVE, DETROIT, MI 48204-2139

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
12/10/2007
Last updated
12/10/2007
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