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General NPI Number Information
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NPI Number | 1013120831
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Entity Type | Organization
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Legal Business Name | RJ & ASSOCIATES DENTAL CARE
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 16372 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48154-3316
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Country | US
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Telephone | 734-422-0800
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Fax | 734-422-5142
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Provider Business Mailing Address
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Address Line | 16372 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48154-3316
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Country | US
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Telephone | 734-422-0800
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Fax | 734-422-5142
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUSTIN GELLER
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Credential | DDS
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Telephone | 734-422-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17995
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License Number State | MI
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