| Periodontic Pllc | |
|
3589 Fort St Wyandotte MI 48192-6315 | |
| (734) 281-1414 | |
| Not Available |
| Full Name | Periodontic Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 3589 Fort St, Wyandotte, Michigan |
| Authorized Official Name and Position | David G Darany (PRESIDENT) |
| Authorized Official Contact | 3132748522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Periodontic Pllc 22801 Newman St. Dearborn MI 48124-1740 Ph: (313) 274-8522 | Periodontic Pllc 3589 Fort St Wyandotte MI 48192-6315 Ph: (734) 281-1414 |
| NPI Number | 1205014669 |
|---|---|
| Provider Enumeration Date | 02/07/2008 |
| Last Update Date | 03/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205014669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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