| Elaine Gantz, D.d.s. | |
|
25865 W 12 Mile Rd Suite D-112 Southfield MI 48034-1817 | |
| (248) 353-4010 | |
| (248) 353-0829 |
| Full Name | Elaine Gantz, D.d.s. |
|---|---|
| Speciality | Dentist |
| Location | 25865 W 12 Mile Rd, Southfield, Michigan |
| Authorized Official Name and Position | Elaine K Gantz (OWNER) |
| Authorized Official Contact | 2483534010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elaine Gantz, D.d.s. 25865 W 12 Mile Rd Suite D-112 Southfield MI 48034-1817 Ph: (248) 353-4010 | Elaine Gantz, D.d.s. 25865 W 12 Mile Rd Suite D-112 Southfield MI 48034-1817 Ph: (248) 353-4010 |
| NPI Number | 1356511950 |
|---|---|
| Provider Enumeration Date | 03/11/2008 |
| Last Update Date | 03/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356511950 | NPI | - | NPPES |
| 1598979676 | Other | MI | NPI |
| 1013996537 | Other | MI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 13299 (Michigan) | Primary |
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