Organization
MICHIGAN DEPARTMENT OF CORRECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONG CHOI (REGIONAL DENTAL DIRECTOR)
(517) 780-5760
Entity
Organization
Contact information
Practice address
17600 RYAN RD, DETROIT, MI 48212-1155
(313) 368-3200
(313) 368-6015
Mailing address
17600 RYAN RD, DETROIT, MI 48212-1155
(313) 368-3200
(313) 368-6015
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
2901014477
MI
251S00000X
Community/Behavioral Health Agency
2901014477
MI
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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