Organization
PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN, LLC
Active
Other names
Refresh Dental Center Line
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JONES (CREDENTIALING SPECIALIST)
(724) 698-2132
Entity
Organization
Contact information
Practice address
23845 VAN DYKE AVE, CENTER LINE, MI 48015-1300
(586) 467-0063
Mailing address
11 S MILL ST, SUITE 200, NEW CASTLE, PA 16101-3613
(724) 698-2500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/03/2017
Last updated
03/13/2017
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