Healthcare Provider Details

I. General information

NPI: 1407994304
Provider Name (Legal Business Name): REPASKY & SWARTS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 E MONROE ST
DUNDEE MI
48131-1380
US

IV. Provider business mailing address

424 E MONROE ST
DUNDEE MI
48131-1380
US

V. Phone/Fax

Practice location:
  • Phone: 734-529-3031
  • Fax: 734-529-5827
Mailing address:
  • Phone: 734-529-3031
  • Fax: 734-529-5827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10538
License Number StateMI

VIII. Authorized Official

Name: DR. DAVID M REPASKY
Title or Position: C.E.O.
Credential: D.D.S., M.P.H.
Phone: 734-529-3031