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1669191342
DIVERSIFIED DENTAL, P.C.
SAINT CLAIR SHORES, MI
NPI
1669191342
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Entity Type
Organization
Authorized Contact
KEVIN D PRUSH
Dentist
586-775-2400
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2022-08-25
Last Update Date
2022-08-25
Business Address
DIVERSIFIED DENTAL, P.C.
30231 JEFFERSON AVE
SAINT CLAIR SHORES, MI 48082-1787
Phone number: 586-775-2400
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Mailing Address
DIVERSIFIED DENTAL, P.C.
30231 JEFFERSON AVE
SAINT CLAIR SHORES, MI 48082-1787
Phone number:
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