Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 41829 Ford Rd., Canton, Michigan |
Authorized Official Name and Position | Rachel Nittinger (MANAGER CREDENTIALING) |
Authorized Official Contact | 9727550816 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
7160 Dallas Pkwy Ste 400 Plano TX 75024-7111 Ph: () - | 41829 Ford Rd. Canton MI 48187 Ph: (734) 983-0128 |
NPI Number | 1639149032 |
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Provider Enumeration Date | 01/26/2006 |
Last Update Date | 02/05/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639149032 | NPI | - | NPPES |
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