Healthcare Provider Details
I. General information
NPI: 1275468860
Provider Name (Legal Business Name): PREMIER DENTAL CENTER, PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
48950 VAN DYKE AVE
SHELBY TOWNSHIP MI
48317-2567
US
IV. Provider business mailing address
48950 VAN DYKE AVE
SHELBY TOWNSHIP MI
48317-2567
US
V. Phone/Fax
- Phone: 248-457-0500
- Fax:
- Phone: 248-457-0500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ARA
NAZARIAN
Title or Position: OWNER
Credential: D.D.S.
Phone: 586-291-9367