Healthcare Provider Details

I. General information

NPI: 1013790898
Provider Name (Legal Business Name): PINCKNEY IMPLANTS & PERIODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 E. MAIN STREET
PINCKNEY MI
48169
US

IV. Provider business mailing address

1245 E. MAIN STREET
PINCKNEY MI
48169
US

V. Phone/Fax

Practice location:
  • Phone: 734-531-7557
  • Fax: 734-531-7558
Mailing address:
  • Phone: 734-531-7557
  • Fax: 734-531-7558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: AMAR KATRANJI
Title or Position: OWNER/PERIODONTIST
Credential: DDS, MS
Phone: 734-975-1743