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General NPI Number Information
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NPI Number | 1043760812
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Entity Type | Organization
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Legal Business Name | ENBRITE DENTAL PLLC
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 416 E POTTAWATAMIE ST
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City | TECUMSEH
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State | MI
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Zip | 49286-2016
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Country | US
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Telephone | 517-301-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 416 E POTTAWATAMIE ST
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City | TECUMSEH
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State | MI
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Zip | 49286-2016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. MATT SCHUSTER
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Credential |
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Telephone | 248-790-5650
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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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