EASTSIDE PERIODONTAL ASSOC PLLC is a periodontics dentist in Center Line, MI. The provider is 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. EASTSIDE PERIODONTAL ASSOC PLLC NPI is 1144312760. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
25523 VAN DYKE AVE CENTER LINE, MI ZIP 48015-824 Phone: (586) 757-5454 Fax: (586) 757-4147
The provider's authorized official is Jennifer Lynn Wise . The authorized official title is Office Manager and has the following contact phone number (586) 757-5454.
The enumeration date for this NPI number is 9/29/2006 and was last updated on 8/22/2020.
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.
This page was last updated on: 3/30/2025
NPI Synchronization or Removal
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