MEDICARE: FILL GOOD DENTAL CENTER PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901017708	MI

General Provider Information

NPI Number	:	1093266215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FILL GOOD DENTAL CENTER PLLC

Provider Business Mailing Address
First Line	:	18750 GRAND RIVER AVE
Second Line	:	102
City	:	DETROIT
State	:	MI
Zip	:	48223
Country	:	US
Telephone Number	:	313-837-3000
Fax Number	:	313-838-4581

Provider Business Practice Location Address
First Line	:	18570 GRAND RIVER AVE
Second Line	:	102
City	:	DETROIT
State	:	MI
Zip	:	48223-2201
Country	:	US
Telephone Number	:	313-837-3000
Fax Number	:	313-838-4581

Authorized Official
Title or Position	:	DOC/PARTNER
Name	:	LAWRENCE STEWART
Credential	:	D.D.S.
Telephone Number	:	313-837-3000

Provider Enumeration Date	:	10/24/2016
Last Update Date	:	10/24/2016

Similar Medicare Providers

1306722194 — CORELIEF REHAB LLC
Practice Location Address:

18570 GRAND RIVER AVE STE 102
DETROIT, MI
48223-2201

Practice Phone: 586-883-3101
Practice Fax:

1417713496 — AFFINITY BLOOM HEALTHCARE AGENCY INC
Practice Location Address:

18570 GRAND RIVER AVE STE 100D
DETROIT, MI
48223-2201

Practice Phone: 313-566-3486
Practice Fax:

1841081908 — OMEGA SPECIALTY GROUP PLC
Practice Location Address:

18570 GRAND RIVER AVE STE 102
DETROIT, MI
48223-2201

Practice Phone: 313-646-4681
Practice Fax: 313-646-4687

1144318924 — CHANTAL GEORGES RPH
Practice Location Address:

4401 CONNER ST
DETROIT, MI
48215-2201

Practice Phone: 313-823-9897
Practice Fax:

1548343429 — MS. NATALI DINKHA RPH
Practice Location Address:

4401 CONNER ST
DETROIT, MI
48215-2201

Practice Phone: 313-823-9897
Practice Fax: 313-823-9884

1821213737 — SHELDON GURA
Practice Location Address:

4401 CONNER ST
DETROIT, MI
48215-2201

Practice Phone: 313-823-9897
Practice Fax: 313-823-9884

Directions to “FILL GOOD DENTAL CENTER PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.