Healthcare Provider Details

I. General information

NPI: 1528276573
Provider Name (Legal Business Name): DRS. PENN AND SEARLS D.D.S. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 FORT ST
TRENTON MI
48183-2040
US

IV. Provider business mailing address

1640 FORT ST
TRENTON MI
48183-2040
US

V. Phone/Fax

Practice location:
  • Phone: 734-675-8400
  • Fax:
Mailing address:
  • Phone: 734-675-8400
  • Fax:

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: DR. GREGORY LEE PENN
Title or Position: PARTNER
Credential: DDS
Phone: 734-675-8400