MEDICARE: DYNAMIC TEACHING

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	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1235584301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNAMIC TEACHING

Provider Business Mailing Address
First Line	:	19453 OAKFIELD ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-2215
Country	:	US
Telephone Number	:	313-702-8272
Fax Number	:

Provider Business Practice Location Address
First Line	:	19453 OAKFIELD ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-2215
Country	:	US
Telephone Number	:	313-702-8272
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. CANDICE BETTS
Credential	:
Telephone Number	:	313-702-8272

Provider Enumeration Date	:	04/26/2016
Last Update Date	:	04/26/2016

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Directions to “DYNAMIC TEACHING ” Practice Location

Language	Start Address	Practice Location

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