| Northeast Dental Group | |
|
21500 Northwestern Hwy Suite 640 Southfield MI 48075-5018 | |
| (248) 552-0166 | |
| Not Available |
| Full Name | Northeast Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 21500 Northwestern Hwy, Southfield, Michigan |
| Authorized Official Name and Position | Debra Grace (OFFICE MANAGER) |
| Authorized Official Contact | 2485520166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Dental Group 21500 Northwestern Hwy Suite 640 Southfield MI 48075-5018 Ph: (248) 552-0166 | Northeast Dental Group 21500 Northwestern Hwy Suite 640 Southfield MI 48075-5018 Ph: (248) 552-0166 |
| NPI Number | 1023195922 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023195922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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