| Prime Dental Pllc | |
|
32905 W 12 Mile Rd Ste 140 Farmington Hills MI 48334-3343 | |
| (248) 987-2879 | |
| (248) 715-6367 |
| Full Name | Prime Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 32905 W 12 Mile Rd Ste 140, Farmington Hills, Michigan |
| Authorized Official Name and Position | Sona Fisenkova (DOCTOR/OWNER) |
| Authorized Official Contact | 2489872879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Dental Pllc 32905 W 12 Mile Rd Ste 140 Farmington Hills MI 48334-3343 Ph: (248) 987-2879 | Prime Dental Pllc 32905 W 12 Mile Rd Ste 140 Farmington Hills MI 48334-3343 Ph: (248) 987-2879 |
| NPI Number | 1720551500 |
|---|---|
| Provider Enumeration Date | 01/04/2019 |
| Last Update Date | 12/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720551500 | NPI | - | NPPES |
| 1811380751 | Other | MI | SELF |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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