Provider First Line Business Practice Location Address:
22615 MICHIGAN AVE
Provider Second Line Business Practice Location Address:
WEST VILLAGE DENTAL CARE
Provider Business Practice Location Address City Name:
DEARBORN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48124-2115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-563-4466
Provider Business Practice Location Address Fax Number:
313-563-1266
Provider Enumeration Date:
12/01/2006