| Modern American Dental Clinic Pc | |
|
14350 W Warren Dearborn MI 48126 | |
| (313) 582-1919 | |
| (313) 582-0300 |
| Full Name | Modern American Dental Clinic Pc |
|---|---|
| Speciality | Dentist |
| Location | 14350 W Warren, Dearborn, Michigan |
| Authorized Official Name and Position | Nabil Berry (DENTIST OWNER) |
| Authorized Official Contact | 3135821919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern American Dental Clinic Pc 14350 W Warren Dearborn MI 48126 Ph: (313) 582-1919 | Modern American Dental Clinic Pc 14350 W Warren Dearborn MI 48126 Ph: (313) 582-1919 |
| NPI Number | 1164510129 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 01/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164510129 | NPI | - | NPPES |
| 4773148 | Medicaid | MI | |
| D15159MI | Other | MI | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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