Eagan Family Dentistry | |
17600 W 12 Mile Road Suite 4 Southfield MI 48076-1910 | |
(248) 569-8770 | |
(248) 569-2476 |
Full Name | Eagan Family Dentistry |
---|---|
Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 17600 W 12 Mile Road, Southfield, Michigan |
Authorized Official Name and Position | Joy Victor Eagan (OWNER) |
Authorized Official Contact | 2485698770 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Eagan Family Dentistry 17600 W 12 Mile Road Suite 4 Southfield MI 48076-1910 Ph: (248) 569-8770 | Eagan Family Dentistry 17600 W 12 Mile Road Suite 4 Southfield MI 48076-1910 Ph: (248) 569-8770 |
NPI Number | 1194861765 |
---|---|
Provider Enumeration Date | 01/30/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194861765 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 13440 (Michigan) | Primary |
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