Northeast Dental Group
NPI #1023195922 in Southfield, Michigan
Provider Information
- NPI Number
- 1023195922
- Entity Type
- Organization
- Organization Name
- Northeast Dental Group
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 1, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 21500 NORTHWESTERN HWY
- Address 2
- SUITE 640
- City
- Southfield
- State
- Michigan
- ZIP Code
- 48075-5018
- Phone
- (248) 552-0166
Authorized Official
- Name
- DEBRA GRACE
- Title
- OFFICE MANAGER
- Phone
- (248) 552-0166
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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