Organization
DELLAVECCHIA DENTAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACEY JEAN DELLAVECCHIA D.D.S. (DENTIST/OWNER)
(269) 857-1431
Entity
Organization
Contact information
Practice address
430 130TH AVE, DOUGLAS, MI 49406-5100
(269) 857-1431
(269) 857-4089
Mailing address
430 130TH AVE, DOUGLAS, MI 49406-5100
(269) 857-1431
(269) 857-4089
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2901018649
MI
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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