| Childrens Dental Program Pllc | |
|
22241 John R Rd Hazel Park MI 48030-1716 | |
| (248) 217-7997 | |
| Not Available |
| Full Name | Childrens Dental Program Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 22241 John R Rd, Hazel Park, Michigan |
| Authorized Official Name and Position | Ifechide Nwabuezr (OWNER) |
| Authorized Official Contact | 2482177997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Dental Program Pllc 22241 John R Rd Hazel Park MI 48030-1716 Ph: (248) 217-7997 | Childrens Dental Program Pllc 22241 John R Rd Hazel Park MI 48030-1716 Ph: (248) 217-7997 |
| NPI Number | 1225602022 |
|---|---|
| Provider Enumeration Date | 05/17/2021 |
| Last Update Date | 05/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225602022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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