| Pro Dental Mi 1 Pc | |
|
1101 E Walton Blvd Ste 300 Pontiac MI 48340-1590 | |
| (248) 499-9989 | |
| (248) 481-9896 |
| Full Name | Pro Dental Mi 1 Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1101 E Walton Blvd Ste 300, Pontiac, Michigan |
| Authorized Official Name and Position | Simone Wilson-adeleke (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 7327318398 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro Dental Mi 1 Pc 10 Woodbridge Center Dr Ste 520 Woodbridge NJ 07095-1152 Ph: (732) 731-8398 | Pro Dental Mi 1 Pc 1101 E Walton Blvd Ste 300 Pontiac MI 48340-1590 Ph: (248) 499-9989 |
| NPI Number | 1063249332 |
|---|---|
| Provider Enumeration Date | 09/19/2024 |
| Last Update Date | 09/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063249332 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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