Healthcare Provider Details

I. General information

NPI: 1316355167
Provider Name (Legal Business Name): TOTAL SMILES DENTAL GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 07/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 TAYLOR ST SUITE A
CHELSEA MI
48118-2301
US

IV. Provider business mailing address

901 TAYLOR ST SUITE A
CHELSEA MI
48118-2301
US

V. Phone/Fax

Practice location:
  • Phone: 734-475-7303
  • Fax: 734-433-4270
Mailing address:
  • Phone: 734-475-7303
  • Fax: 734-433-4270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number15648
License Number StateMI

VIII. Authorized Official

Name: KELLY ANN SCHERR
Title or Position: OWNER/DOCTOR
Credential: DDS
Phone: 734-475-7303