Adiram Family Dentistry
Dentist in Mount Clemens, MI. Organization (NPI-2).
NPI number1295113165
StatusActive
Last updated in NPPESSep 29, 2016
Details
- NPI
- 1295113165
- Entity type
- Organization (NPI-2)
- Legal business name
- Adiram Family Dentistry
- Organization subpart
- No
- Enumeration date
- May 12, 2015
- Last updated
- Sep 29, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Other names
- Riverside Family Dental (Doing Business As)
Practice location
253 S Gratiot AveMount Clemens, MI 48043-2425
Phone 586-468-0983 · Fax 586-468-9661
Mailing address
253 S Gratiot AveMount Clemens, MI 48043-2425
Phone 586-468-0983 · Fax 586-468-9661
Authorized official
Ramakrishna Nallapaneni
Owner
5864680983
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