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NPI Code Detail

MEDICARE: DOKU DENTAL OF ST. CLAIR SHORES PLLC

MEDICARE: DOKU DENTAL OF ST. CLAIR SHORES 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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1720978067
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOKU DENTAL OF ST. CLAIR SHORES PLLC
Provider Business Mailing Address
First Line : 25815 HARPER AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48081-2263
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 25815 HARPER AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48081-2263
Country : US
Telephone Number : 586-772-8080
Fax Number :
Authorized Official
Title or Position : DDS
Name : REZAN DOKU
Credential :
Telephone Number : 586-250-3990
Provider Enumeration Date : 07/08/2025
Last Update Date : 07/08/2025

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Directions to “DOKU DENTAL OF ST. CLAIR SHORES PLLC ” Practice Location

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