Liberty Corners Dental Pllc | |
7298 Jackman Rd Temperance MI 48182-1313 | |
(734) 847-6350 | |
Not Available |
Full Name | Liberty Corners Dental Pllc |
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Speciality | Dentist |
Location | 7298 Jackman Rd, Temperance, Michigan |
Authorized Official Name and Position | Larry Mizelle (DENTIST) |
Authorized Official Contact | 7348476350 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Liberty Corners Dental Pllc 7298 Jackman Rd Temperance MI 48182-1313 Ph: (734) 847-6350 | Liberty Corners Dental Pllc 7298 Jackman Rd Temperance MI 48182-1313 Ph: (734) 847-6350 |
NPI Number | 1699938589 |
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Provider Enumeration Date | 07/09/2008 |
Last Update Date | 07/09/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699938589 | NPI | - | NPPES |
2901010910 | Other | MI | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 2901010910 (Michigan) | Primary |
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