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NPI Code Detail

MEDICARE: CAMBRIDGE DENTAL GROUP

MEDICARE: CAMBRIDGE DENTAL GROUP
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1023213196
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMBRIDGE DENTAL GROUP
Provider Business Mailing Address
First Line : 27281 W WARREN ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-1804
Country : US
Telephone Number : 313-274-4040
Fax Number : 313-274-8080
Provider Business Practice Location Address
First Line : 27281 W WARREN ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-1804
Country : US
Telephone Number : 313-274-4040
Fax Number : 313-274-8080
Authorized Official
Title or Position : ADMINISTRATOR
Name : CHRISTINE MARIE SOMMERS
Credential :
Telephone Number : 313-274-4040
Provider Enumeration Date : 06/19/2007
Last Update Date : 08/22/2020

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Directions to “CAMBRIDGE DENTAL GROUP ” Practice Location

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