| Southgate Ardent Pllc | |
|
13703 Northline Rd Southgate MI 48195-1866 | |
| (734) 284-8088 | |
| (734) 284-0522 |
| Full Name | Southgate Ardent Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 13703 Northline Rd, Southgate, Michigan |
| Authorized Official Name and Position | Laura Burkeen (MANAGER) |
| Authorized Official Contact | 7342848088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southgate Ardent Pllc 13703 Northline Rd Southgate MI 48195-1866 Ph: (734) 284-8088 | Southgate Ardent Pllc 13703 Northline Rd Southgate MI 48195-1866 Ph: (734) 284-8088 |
| NPI Number | 1225779325 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 04/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225779325 | NPI | - | NPPES |
| 1447822572 | Other | MI | NPI |
| 1053768432 | Other | MI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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