Healthcare Provider Details

I. General information

NPI: 1386140218
Provider Name (Legal Business Name): CATHERINE ANNE PIASKOWSKI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE ANNE SCHRICKER DDS

II. Dates (important events)

Enumeration Date: 03/31/2018
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5716 MICHIGAN AVE.
DETROIT MI
48210
US

IV. Provider business mailing address

5716 MICHIGAN AVE.
DETROIT MI
48210
US

V. Phone/Fax

Practice location:
  • Phone: 313-554-3880
  • Fax: 313-899-3550
Mailing address:
  • Phone: 313-554-0485
  • Fax: 313-228-0283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2901600893
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901600893
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: