| Pllc | |
|
15400 Grand River Ave Ste 4 Detroit MI 48227-4129 | |
| (313) 837-3000 | |
| (313) 838-4581 |
| Full Name | Pllc |
|---|---|
| Speciality | Dentist |
| Location | 15400 Grand River Ave Ste 4, Detroit, Michigan |
| Authorized Official Name and Position | Lawrence W Stewart (OWNER/DENTIST) |
| Authorized Official Contact | 3138373000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pllc 15400 Grand River Ave Ste 4 Detroit MI 48227-4129 Ph: (313) 837-3000 | Pllc 15400 Grand River Ave Ste 4 Detroit MI 48227-4129 Ph: (313) 837-3000 |
| NPI Number | 1306019609 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306019609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 017708 (Michigan) | Primary |
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