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General NPI Number Information
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NPI Number | 1245392307
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Entity Type | Organization
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Legal Business Name | WASHTENAW GENERAL DENTISTRY ASSOCIATES
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3075 W CLARK ROAD SUITE 209
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City | YPSILANTI
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State | MI
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Zip | 48197
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Country | US
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Telephone | 734-434-6020
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Fax | 734-434-6151
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Provider Business Mailing Address
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Address Line | 3075 W CLARK ROAD SUITE 209
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City | YPSILANTI
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State | MI
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Zip | 48197
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Country | US
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Telephone | 734-434-6020
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Fax | 734-434-6151
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS A PARMENTER
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Credential | DDS
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Telephone | 734-434-6020
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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 | 16759
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 11107
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 16429
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License Number State | MI
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