Organization · Type 2 NPI
Periodontic PLLC
Periodontics · Wyandotte, MI
NPI number
1205014669
Active
Practice location
3589 Fort St
Wyandotte, MI 48192-6315
Mailing address
22801 Newman St.
Dearborn, MI 48124-1740
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | None listed |
Periodontics: 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 structures and tissues.
About NPI 1205014669
Periodontic PLLC's National Provider Identifier is 1205014669, issued on Feb 7, 2008. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Wyandotte, MI. The record was last updated on Mar 14, 2013.