| Lathrup Family Dentistry | |
|
28625 Southfield Rd Lathrup Village MI 48076-2701 | |
| (248) 569-2056 | |
| (248) 569-8987 |
| Full Name | Lathrup Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 28625 Southfield Rd, Lathrup Village, Michigan |
| Authorized Official Name and Position | Mason Haddow (PRESIDENT/DENTIST) |
| Authorized Official Contact | 2485692056 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lathrup Family Dentistry 28625 Southfield Rd Lathrup Village MI 48076-2701 Ph: () - | Lathrup Family Dentistry 28625 Southfield Rd Lathrup Village MI 48076-2701 Ph: (248) 569-2056 |
| NPI Number | 1235305301 |
|---|---|
| Provider Enumeration Date | 05/07/2008 |
| Last Update Date | 05/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235305301 | NPI | - | NPPES |
| 1842223 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 14801 (Michigan) | Primary |
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