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NPI Code Detail

MEDICARE: DOWNTOWN DENTAL STUDIO, PLLC

MEDICARE: DOWNTOWN DENTAL STUDIO, 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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1871189423
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOWNTOWN DENTAL STUDIO, PLLC
Provider Business Mailing Address
First Line : 107 E WASHTENAW ST
Second Line :
City : LANSING
State : MI
Zip : 48933-1822
Country : US
Telephone Number : 517-487-5666
Fax Number :
Provider Business Practice Location Address
First Line : 107 E WASHTENAW ST
Second Line :
City : LANSING
State : MI
Zip : 48933-1822
Country : US
Telephone Number : 517-487-5666
Fax Number :
Authorized Official
Title or Position : OWNER
Name : PRIYANKA WATWE
Credential : DDS
Telephone Number : 248-880-2445
Provider Enumeration Date : 12/17/2020
Last Update Date : 12/17/2020

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Directions to “DOWNTOWN DENTAL STUDIO, PLLC ” Practice Location

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