Provident Dentistry

NPI #1407887656 in Novi, Michigan

Provider Information

NPI Number: 1407887656
Entity Type: Organization
Organization Name: Provident Dentistry
Primary Specialty: Dentist
Enumeration Date: Jul 5, 2006
Last Updated: Jul 23, 2008

Practice Location

Address: 40105 GRAND RIVER AVE
Address 2: SUITE 1
City: Novi
State: Michigan
ZIP Code: 48375-2170
Phone: (248) 471-0345

Authorized Official

Name: DR. ALAN JEFFREY KESSLER, D.D.S.
Title: SECRETARY
Phone: (248) 471-0345

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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