Healthcare Provider Details

I. General information

NPI: 1306752613
Provider Name (Legal Business Name): MACOMB EMERGENCY DENTAL CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37300 SCHOENHERR RD STE A
STERLING HEIGHTS MI
48312-2312
US

IV. Provider business mailing address

37300 SCHOENHERR RD STE A
STERLING HEIGHTS MI
48312-2312
US

V. Phone/Fax

Practice location:
  • Phone: 586-942-9204
  • Fax: 586-977-8512
Mailing address:
  • Phone: 586-942-9204
  • Fax: 586-977-8512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DEANNA SKOWRONSKI
Title or Position: OWNER
Credential: DMD
Phone: 586-419-3493