| Premier Dental Pc | |
|
22801 Newman St Dearborn MI 48124-2200 | |
| (313) 274-8522 | |
| (313) 274-5396 |
| Full Name | Premier Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 22801 Newman St, Dearborn, Michigan |
| Authorized Official Name and Position | Pota A Rakes (OWNER) |
| Authorized Official Contact | 4029812996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Dental Pc 22801 Newman St Dearborn MI 48124-2200 Ph: (313) 274-8522 | Premier Dental Pc 22801 Newman St Dearborn MI 48124-2200 Ph: (313) 274-8522 |
| NPI Number | 1366721292 |
|---|---|
| Provider Enumeration Date | 08/09/2011 |
| Last Update Date | 09/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366721292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901020370 (Michigan) | Primary |
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