Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pro Dental Mi 1 PC

Organization General Practice Dentistry · NPI 1912734286

Pro Dental Mi 1 PC is a General Practice Dentistry in Detroit, Michigan. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

14736 Mack Ave
Detroit, MI 48215-2524
Phone: (313) 412-2100
Fax: (313) 766-7734
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1912734286
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Simone Wilson-Adeleke — Director Of Credentialing · (732) 731-8398
Other names Destiny Dental Of Mack
NPI enumeratedSeptember 19, 2024
Last updated in NPPESSeptember 19, 2024
Certification dateSeptember 19, 2024
Mailing address10 Woodbridge Center Dr Ste 520, Woodbridge, NJ 07095-1152

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