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General NPI Number Information
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NPI Number | 1124772330
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Entity Type | Organization
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Legal Business Name | DAVID M. EBERHARD DDS PC
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 02/07/2022
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Provider Practice Location Address
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Address Line | 44710 VAN DYKE AVE
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City | UTICA
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State | MI
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Zip | 48317-5481
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Country | US
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Telephone | 586-739-0550
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Fax | 586-739-5226
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Provider Business Mailing Address
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Address Line | 16 NORWICH RD
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City | PLEASANT RIDGE
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State | MI
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Zip | 48069-1026
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Country | US
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Telephone | 313-418-0699
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID M EBERHARD
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Credential | DDS
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Telephone | 313-418-0699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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