Provider First Line Business Practice Location Address:
DETROIT HEALTH DEPT. - HERMAN KIEFER HEALTH COMPLEX
Provider Second Line Business Practice Location Address:
1151 TAYLOR STREET, 7TH FLOOR PEDIATRIC DENTAL CLINIC
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48202-1732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-876-4087
Provider Business Practice Location Address Fax Number:
313-871-1589
Provider Enumeration Date:
03/09/2007