| City Of Detroit | |
|
1151 Taylor St 323 C Detroit MI 48202-1732 | |
| (313) 876-4307 | |
| (313) 876-0475 |
| Full Name | City Of Detroit |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 1151 Taylor St, Detroit, Michigan |
| Authorized Official Name and Position | Kanzoni Asabigi (GENERAL MANAGER, COMMUNITY HEALTH) |
| Authorized Official Contact | 3138764000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Of Detroit 1151 Taylor St 323 C Detroit MI 48202-1732 Ph: (313) 876-4307 | City Of Detroit 1151 Taylor St 323 C Detroit MI 48202-1732 Ph: (313) 876-4307 |
| NPI Number | 1760701262 |
|---|---|
| Provider Enumeration Date | 05/24/2010 |
| Last Update Date | 06/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760701262 | NPI | - | NPPES |
| 445991 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Primary |
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