Individual
ELIZABETH IDELL EASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5716 MICHIGAN AVE, DETROIT, MI 48210-3039
(313) 554-3880
(313) 554-8115
Mailing address
559 W GRAND BLVD, DETROIT, MI 48216-2200
(313) 554-0485
(313) 228-0283
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902016546
MI
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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