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Individual

ALECO E TUJIOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1500 E MEDICAL CENTER DR, B1B204, ANN ARBOR, MI 48109-0018
(734) 936-3072
(734) 763-8100
Mailing address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 936-3072
(734) 763-8100

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2901018634
MI
1223P0221X
Pediatric Dentistry
Primary
2901018634
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D186340
BCBS OF MI DENTAL
MI
Enumeration date
03/19/2007
Last updated
02/16/2012
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