Healthcare Provider Details

I. General information

NPI: 1760689350
Provider Name (Legal Business Name): ALMONT DENTAL CENTRE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 N MAIN ST
ALMONT MI
48003-8553
US

IV. Provider business mailing address

PO BOX 465 606 N. MAIN
ALMONT MI
48003-0465
US

V. Phone/Fax

Practice location:
  • Phone: 810-798-8585
  • Fax:
Mailing address:
  • Phone: 810-798-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14481
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number19399
License Number StateMI

VIII. Authorized Official

Name: DENISE NEDDERMEYER
Title or Position: BUSINESS COORDINATOR
Credential:
Phone: 810-798-8585