Individual
BENJAMIN THOMAS BARBETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202
(313) 916-2600
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2901022095
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
4301113606
MI
Other
Enumeration date
03/02/2011
Last updated
01/27/2025
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