Shadows O.Bedell Dds.P.C.
General Practice Dentistry in Detroit, MI(View on Map)
Legal Business Name
Shadows O.Bedell Dds.P.C.
NPI Number
1427247758
NPI Type
Organization
Enumeration Date
10/23/2007
Specialties
(Taxonomies)Licenses
State
Michigan
License Number
12360
Contact
Information
Purpose
Mailing
Location
Address
19600 VAN DYKE ST
19600 VAN DYKE ST
City
Detroit
Detroit
State
MI
MI
Postal Code
48234-3325
48234-3325
Country
US
US
Telephone Number
(313) 892-9148
(313) 892-9148
Authorized Official
Name
Dr. Shadows Bedell
Title or Position
DENTIST
Telephone Number
(313) 892-9148
Identifiers
Identifier
1720148018
1801967757
1083663702
Identifier State
MI
MI
MI
Identifier Issuer
Unknown
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/02/2007
Provider Address
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