| Legacy Dental Group | |
|
950 S Old Woodward Ave Ste 200 Birmingham MI 48009-6719 | |
| (248) 644-9120 | |
| (248) 282-5060 |
| Full Name | Legacy Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 950 S Old Woodward Ave Ste 200, Birmingham, Michigan |
| Authorized Official Name and Position | Jeffrey C. Grabiel (OWNER/DENTIST) |
| Authorized Official Contact | 2486443131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Dental Group 950 S Old Woodward Ave Ste 200 Birmingham MI 48009-6719 Ph: (248) 644-9120 | Legacy Dental Group 950 S Old Woodward Ave Ste 200 Birmingham MI 48009-6719 Ph: (248) 644-9120 |
| NPI Number | 1477894442 |
|---|---|
| Provider Enumeration Date | 03/15/2013 |
| Last Update Date | 04/10/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477894442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 012169 (Michigan) | Primary |
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