| Wide Smiles Mobile Dental | |
|
19332 Hudson River Dr Macomb MI 48044-4241 | |
| (586) 649-7906 | |
| (586) 231-0118 |
| Full Name | Wide Smiles Mobile Dental |
|---|---|
| Speciality | Dentist |
| Location | 19332 Hudson River Dr, Macomb, Michigan |
| Authorized Official Name and Position | Douglas Joseph Shoha (OWNER) |
| Authorized Official Contact | 5866497906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wide Smiles Mobile Dental 19332 Hudson River Dr Macomb MI 48044-4241 Ph: (586) 649-7906 | Wide Smiles Mobile Dental 19332 Hudson River Dr Macomb MI 48044-4241 Ph: (586) 649-7906 |
| NPI Number | 1255768818 |
|---|---|
| Provider Enumeration Date | 09/27/2013 |
| Last Update Date | 09/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255768818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 16556 (Michigan) | Primary |
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