Periodontic Pllc in Dearborn - Periodontics
Periodontic Pllc - NPI 1629256094
Periodontic Pllc is a Periodontics in Dearborn, Michigan. Periodontic Pllc practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Periodontic Pllc is 1629256094. The last update date is 2013-03-14.
Periodontic Pllc's current location address is 22801 Newman St, Dearborn, Michigan. You can contact this provider via phone number 3132748522 and fax number 3132745396. The mailing address for Periodontic Pllc is 22801 Newman St, Dearborn, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Periodontic Pllc |
|---|---|
| Address | 22801 Newman St, Dearborn, Michigan |
| Phone Number | 3132748522 |
| Fax Number | 3132745396 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Darany G David |
| Credentials | DDS, MS |
| Telephone Number | 3132748522 |
NPI Number Detail
| NPI Number | 1629256094 |
|---|---|
| Provider Enumeration Date | 2008-02-07 |
| Last Updated Date | 2013-03-14 |
Provider Mailing Address Detail
| Address | 22801 Newman St |
|---|---|
| City | Dearborn |
| State | Michigan (MI) |
| Post Code | 481242200 |
| Phone Number | 3132748522 |
| Fax Number | 3132745396 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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What is the unique 10-digit identifier code assigned to Periodontic Pllc by the Centers for Medicare & Medicaid Services?
The Periodontic Pllc has been issued the NPI (National Provider Identifier) 1629256094 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Periodontic Pllc?
The Periodontic Pllc is situated at 22801 Newman St, in the city of Dearborn, state of MI, with the zip code 481242200.
What is the area of specialization for Periodontic Pllc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Periodontic Pllc is Periodontics, and the corresponding taxonomy code that categorizes this area of expertise is 1223P0300X.
On what date did the Periodontic Pllc receive the assignment of its 1629256094 from the Centers for Medicare & Medicaid Services?
The Periodontic Pllc was issued its 1629256094 by the Centers for Medicare & Medicaid Services on 2008-02-07.
As of what date were the details pertaining to Periodontic Pllc last refreshed?
The information related to the Periodontic Pllc, including its address, specialty, and other relevant details, was last updated on 2013-03-14.
NPI Number: 1528061793
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