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SQUARE LAKE FAMILY DENTISTRY NPI 1558442202


NPI Information

NPI: 1558442202
Provider Name: SQUARE LAKE FAMILY DENTISTRY
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
6053 ROCHESTER RD
TROY, MI
ZIP 48085
Phone: (248) 879-5858
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SQUARE LAKE FAMILY DENTISTRY is a general practice dentist in Troy, MI. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SQUARE LAKE FAMILY DENTISTRY NPI is 1558442202. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6053 ROCHESTER RD
TROY, MI
ZIP 48085-303
Phone: (248) 879-5858
Fax: (248) 879-3578

The provider's authorized official is Pritida Tushar Patel .
The authorized official title is Secretary and has the following contact phone number (248) 879-5858.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 1/31/2008.


Taxonomy Codes

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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice2901015929MICHIGANNo
21223G0001XDentistGeneral Practice2901015961MICHIGANYes

What is NPI?

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: 4/28/2024

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