A1 Family Dentistry Of Waterford,plc
Clinic/Center, Dental in Waterford, MI. Organization (NPI-2).
NPI number1578023883
StatusActive
Last updated in NPPESMar 22, 2019
Details
- NPI
- 1578023883
- Entity type
- Organization (NPI-2)
- Legal business name
- A1 Family Dentistry Of Waterford,plc
- Organization subpart
- No
- Enumeration date
- Mar 22, 2019
- Last updated
- Mar 22, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
2759 Elizabeth Lake RdWaterford, MI 48328-3291
Phone 586-226-0638
Mailing address
50481 Koss DrMacomb, MI 48044-6320
Phone 586-226-0638
Authorized official
Aneel Kaur Randhawa
Owner
5862260638
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