| Dacorona Dds Pllc | |
|
13874 Grand River Ave Detroit MI 48227-3123 | |
| (313) 834-4900 | |
| Not Available |
| Full Name | Dacorona Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 13874 Grand River Ave, Detroit, Michigan |
| Authorized Official Name and Position | Dennis Corona (OWNER) |
| Authorized Official Contact | 9418095946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dacorona Dds Pllc 27201 Ryan Rd Warren MI 48092-5127 Ph: () - | Dacorona Dds Pllc 13874 Grand River Ave Detroit MI 48227-3123 Ph: (313) 834-4900 |
| NPI Number | 1275234999 |
|---|---|
| Provider Enumeration Date | 03/10/2023 |
| Last Update Date | 03/10/2023 |
| Medicare PECOS PAC ID | 9830559772 |
|---|---|
| Medicare Enrollment ID | O20230724002385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275234999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Richard M Golden |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1063521144 PECOS PAC ID: 9335448059 Enrollment ID: I20230724003216 |
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