Healthcare Provider Details

I. General information

NPI: 1164506135
Provider Name (Legal Business Name): PLYMOUTH DENTAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42801 SCHOOLCRAFT ROAD
PLYMOUTH MI
48170
US

IV. Provider business mailing address

42801 SCHOOLCRAFT ROAD
PLYMOUTH MI
48170
US

V. Phone/Fax

Practice location:
  • Phone: 734-420-2326
  • Fax: 734-420-0078
Mailing address:
  • Phone: 734-420-2326
  • Fax: 734-420-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number12363
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18376
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9839
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8396
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10260
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number15827
License Number StateMI
# 7
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number16429
License Number StateMI
# 8
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11810
License Number StateMI

VIII. Authorized Official

Name: MRS. MARGARET A ZARB
Title or Position: ACCOUNTS RECEIVABLE INSURANCE MGR
Credential:
Phone: 734-420-2326