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General NPI Number Information
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NPI Number | 1093047326
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Entity Type | Organization
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Legal Business Name | PERSONALIZED DENTAL CARE PLLC
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 2532 MONROE ST
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City | DEARBORN
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State | MI
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Zip | 48124-3014
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Country | US
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Telephone | 313-563-9090
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Fax | 313-563-8237
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Provider Business Mailing Address
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Address Line | 2532 MONROE
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City | DEARBORN
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State | MI
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Zip | 48124-3014
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Country | US
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Telephone | 313-563-9090
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Fax | 313-563-8237
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Authorized Official
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Title or Position | DENTIST
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Name | DR. AMIT BATRA
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Credential | D.D.S
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Telephone | 313-563-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 015018
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License Number State | MI
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