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NPI Code Detail

MEDICARE: TOOTH AND WAFFLES, PLLC

MEDICARE: TOOTH AND WAFFLES, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry

General Provider Information

NPI Number : 1487343133
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOOTH AND WAFFLES, PLLC
Provider Business Mailing Address
First Line : 1104 PARK PLACE COURT
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302
Country : US
Telephone Number : 412-327-9193
Fax Number :
Provider Business Practice Location Address
First Line : 40053 8 MILE RD STE 200
Second Line :
City : NORTHVILLE
State : MI
Zip : 48167-1954
Country : US
Telephone Number : 248-444-6223
Fax Number : 248-710-2209
Authorized Official
Title or Position : OWNER
Name : DR. DANNY KALASH
Credential : DMD, MPH
Telephone Number : 248-444-6223
Provider Enumeration Date : 05/08/2023
Last Update Date : 09/18/2024

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Directions to “TOOTH AND WAFFLES, PLLC ” Practice Location

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