Healthcare Provider Details

I. General information

NPI: 1124134945
Provider Name (Legal Business Name): ARNOLD L TRACHT DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 S ROCHESTER RD
ROCHESTER HILLS MI
48307-3532
US

IV. Provider business mailing address

1814 S ROCHESTER RD
ROCHESTER HILLS MI
48307-3532
US

V. Phone/Fax

Practice location:
  • Phone: 248-608-2626
  • Fax: 248-608-8149
Mailing address:
  • Phone: 248-608-2626
  • Fax: 248-608-8149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number2901010495
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: