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General NPI Number Information
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NPI Number | 1033969332
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Entity Type | Organization
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Legal Business Name | DELUXE DENTAL ASSOCIATES 9-WARREN PLLC
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 29170 HOOVER RD
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City | WARREN
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State | MI
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Zip | 48093-3476
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Country | US
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Telephone | 810-820-7766
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Fax | 810-243-0454
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Provider Business Mailing Address
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Address Line | 29170 HOOVER RD
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City | WARREN
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State | MI
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Zip | 48093-3476
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Country | US
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Telephone | 810-820-7766
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Fax | 810-243-0454
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMBER MIKHA-KIZY
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Credential | DDS
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Telephone | 810-820-7766
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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 |
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License Number State |
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