Organization

Downriver Dental Associates P.C.

Legal Business Name

Downriver Dental Associates P.C.

NPI Number

1336231497

NPI Type

Organization

Enumeration Date

09/28/2006

Specialties

(Taxonomies)

Code

122300000X
1223P0300X

Primary Taxonomy

No
No

Contact
Information

Purpose

Mailing
Location

Address

3830 FORT ST.
3830 FORT STREET

City

Lincoln Park
Lincoln Park

State

MI
MI

Postal Code

48146
48146

Country

US
US

Telephone Number

(313) 383-6800
(313) 383-6800

Authorized Official

Name

Dr. Ronald Grumet

Title or Position

VICE-PRESIDENT

Telephone Number

(313) 383-6800

Identifiers

Identifier

D803850

Identifier State

MI

Identifier Issuer

BLUE CROSS/BLUE SHIELD

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2020

Provider Address