| Wayne State University Physician Group | |
|
4201 Saint Antoine St Suite 5g Detroit MI 48201-2153 | |
| (313) 745-4095 | |
| (313) 577-8555 |
| Full Name | Wayne State University Physician Group |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 4201 Saint Antoine St, Detroit, Michigan |
| Authorized Official Name and Position | Jeffery P Kohlitz (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2485815930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne State University Physician Group 1560 E. Maple Rd. Suite 400-credentialing Dept. Troy MI 48083-1138 Ph: (248) 581-5973 | Wayne State University Physician Group 4201 Saint Antoine St Suite 5g Detroit MI 48201-2153 Ph: (313) 745-4095 |
| NPI Number | 1275572075 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 10/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275572075 | NPI | - | NPPES |
| 0P32160 | Other | MI | MEDICARE GROUP # - DDS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | (* (Not Available)) | Primary |
Advantage Health Centers Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15400 W Mcnichols Rd, Detroit, MI 48235 Phone: 313-416-6262 Fax: 313-221-8217 | |
Pdc Managemen Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5831 W Vernor Hwy, Detroit, MI 48209 Phone: 313-842-8300 Fax: 313-842-8530 | |
Smiley Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15510 Livernois Ave, Detroit, MI 48238 Phone: 313-863-2800 Fax: 313-863-5054 | |
Allenandallendental & Associates P.c Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10720 W 7 Mile Road, Detroit, MI 48221 Phone: 313-345-4444 Fax: 313-345-4106 | |
Super Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15510 Livernois Ave, Detroit, MI 48238 Phone: 313-863-2800 | |
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 | |
University Otolaryngology Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4201 Saint Antoine St, Suite 5g, Detroit, MI 48201 Phone: 313-745-4656 |