| Shadows O.bedell Dds.p.c. | |
|
19600 Van Dyke St Detroit MI 48234-3325 | |
| (313) 892-9148 | |
| (313) 892-0204 |
| Full Name | Shadows O.bedell Dds.p.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 19600 Van Dyke St, Detroit, Michigan |
| Authorized Official Name and Position | Shadows O Bedell (DENTIST) |
| Authorized Official Contact | 3138929148 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shadows O.bedell Dds.p.c. 19600 Van Dyke St Detroit MI 48234-3325 Ph: (313) 892-9148 | Shadows O.bedell Dds.p.c. 19600 Van Dyke St Detroit MI 48234-3325 Ph: (313) 892-9148 |
| NPI Number | 1427247758 |
|---|---|
| Provider Enumeration Date | 10/23/2007 |
| Last Update Date | 11/02/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427247758 | NPI | - | NPPES |
| 1720148018 | Medicaid | MI | |
| 1801967757 | Medicaid | MI | |
| 1083663702 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12360 (Michigan) | Primary |
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Megan M Faircloth Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3374 E Jefferson Ave, Detroit, MI 48207 Phone: 313-259-2410 | |
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