| Redwood Dental Group | |
|
6511 N Canton Center Rd Canton MI 48187-1653 | |
| (248) 577-5188 | |
| Not Available |
| Full Name | Redwood Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6511 N Canton Center Rd, Canton, Michigan |
| Authorized Official Name and Position | Mark A Bouchillon (PRESIDENT) |
| Authorized Official Contact | 15869792800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Redwood Dental Group 255 W 13 Mile Rd Suite #100 Madison Heights MI 48071-1868 Ph: (734) 722-5130 | Redwood Dental Group 6511 N Canton Center Rd Canton MI 48187-1653 Ph: (248) 577-5188 |
| NPI Number | 1164893392 |
|---|---|
| Provider Enumeration Date | 10/14/2015 |
| Last Update Date | 10/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164893392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Michigan) | Primary |
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