| Edward Street Dental | |
|
707 E 12 Mile Rd Madison Heights MI 48071-2533 | |
| (248) 548-6110 | |
| (248) 548-2718 |
| Full Name | Edward Street Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 707 E 12 Mile Rd, Madison Heights, Michigan |
| Authorized Official Name and Position | Kevin M Homer (OWNER) |
| Authorized Official Contact | 2485486110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Street Dental 707 E 12 Mile Rd Madison Heights MI 48071-2533 Ph: (248) 548-6110 | Edward Street Dental 707 E 12 Mile Rd Madison Heights MI 48071-2533 Ph: (248) 548-6110 |
| NPI Number | 1700864527 |
|---|---|
| Provider Enumeration Date | 01/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700864527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 17110 (Michigan) | Primary |
| 1223G0001X | Dentist - General Practice | 13530 (Michigan) | Secondary |
Gentle Dental John R Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 28780 John R Rd, Madison Heights, MI 48071 Phone: 248-547-7800 | |
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