Healthcare Provider Details

I. General information

NPI: 1437246444
Provider Name (Legal Business Name): CLAIRPOINTE FAMILY DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 08/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23995 GREATER MACK AVE SUITE 200
ST. CLAIR SHORES MI
48080
US

IV. Provider business mailing address

23995 GREATER MACK AVE SUITE 200
ST. CLAIR SHORES MI
48080
US

V. Phone/Fax

Practice location:
  • Phone: 586-775-1040
  • Fax: 586-775-9940
Mailing address:
  • Phone: 586-775-1040
  • Fax: 586-775-9940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14531
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELE T. YESTER
Title or Position: OFFICE MANAGER
Credential:
Phone: 586-775-1040