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General NPI Number Information
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NPI Number | 1194688952
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Entity Type | Organization
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Legal Business Name | MICHIGAN DENTAL STUDIO ROCHESTER
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1202 WALTON BLVD STE 202
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-6918
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Country | US
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Telephone | 248-651-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 1202 WALTON BLVD STE 202
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-6918
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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 | OFFICE MANAGER
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Name | JENNIFER BARNES
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Credential |
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Telephone | 517-546-8983
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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 |
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License Number State |
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