Eastside Periodontal Assoc Pllc
NPI #1144312760 in Center Line, Michigan
Provider Information
- NPI Number
- 1144312760
- Entity Type
- Organization
- Organization Name
- Eastside Periodontal Assoc Pllc
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Sep 29, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 25523 VAN DYKE AVE
- City
- Center Line
- State
- Michigan
- ZIP Code
- 48015-1824
- Phone
- (586) 757-5454
Authorized Official
- Name
- MRS. JENNIFER LYNN WISE
- Title
- OFFICE MANAGER
- Phone
- (586) 757-5454
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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Organizations
| Provider Name | |
|---|---|
| Eastside Implants & Periodontics Part of Michigan Implants & Periodontics Institute, P.l.c. | AI Deep Dive |
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