Edward Street Dental
NPI #1700864527 in Madison Heights, Michigan
Provider Information
- NPI Number
- 1700864527
- Entity Type
- Organization
- Organization Name
- Edward Street Dental
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 3, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 707 E 12 MILE RD
- City
- Madison Heights
- State
- Michigan
- ZIP Code
- 48071-2533
- Phone
- (248) 548-6110
Authorized Official
- Name
- DR. KEVIN M HOMER, DDS
- Title
- OWNER
- Phone
- (248) 548-6110
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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