Individual
CASEY GOETTLICHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
37595 7 MILE RD, #450, LIVONIA, MI 48152-1003
(734) 855-4474
Mailing address
37595 7 MILE RD, #450, LIVONIA, MI 48152-1003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021989
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962854745
—
MI
Enumeration date
07/06/2016
Last updated
02/07/2017
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