| Michigan Center For Oral Surgery | |
|
22150 Allen Rd Woodhaven MI 48183-2271 | |
| (734) 675-1520 | |
| (734) 675-2118 |
| Full Name | Michigan Center For Oral Surgery |
|---|---|
| Speciality | Clinic/Center |
| Location | 22150 Allen Rd, Woodhaven, Michigan |
| Authorized Official Name and Position | Dexter Kert Flemming (OWNER) |
| Authorized Official Contact | 7346751520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Center For Oral Surgery 22150 Allen Rd Woodhaven MI 48183-2271 Ph: (734) 675-1520 | Michigan Center For Oral Surgery 22150 Allen Rd Woodhaven MI 48183-2271 Ph: (734) 675-1520 |
| NPI Number | 1710153713 |
|---|---|
| Provider Enumeration Date | 04/30/2008 |
| Last Update Date | 04/30/2008 |
| Medicare PECOS PAC ID | 2860535960 |
|---|---|
| Medicare Enrollment ID | O20100211000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710153713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2901017976 (Michigan) | Primary |
| Provider Name | Dexter K Flemming |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1174663611 PECOS PAC ID: 5193781615 Enrollment ID: I20041207000486 |
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