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30060 23 Mile Rd Chesterfield MI 48047-5718 | |
| (586) 949-2240 | |
| (586) 949-2243 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 30060 23 Mile Rd, Chesterfield, Michigan |
| Authorized Official Name and Position | Karen L Lenard (OFFICE MANAGER) |
| Authorized Official Contact | 5869492240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
30060 23 Mile Rd Chesterfield MI 48047-5718 Ph: (586) 949-2240 | 30060 23 Mile Rd Chesterfield MI 48047-5718 Ph: (586) 949-2240 |
| NPI Number | 1508069907 |
|---|---|
| Provider Enumeration Date | 06/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508069907 | NPI | - | NPPES |
| 4576013 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2901017682 (Michigan) | Primary |
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