Healthcare Provider Details

I. General information

NPI: 1447019047
Provider Name (Legal Business Name): TEAM CARES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3646 MOUNT ELLIOTT ST
DETROIT MI
48207-2311
US

IV. Provider business mailing address

PO BOX 81088
ROCHESTER MI
48308-1088
US

V. Phone/Fax

Practice location:
  • Phone: 313-626-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN DERY
Title or Position: SECRETARY/TREASURER
Credential:
Phone: 248-310-6338