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General NPI Number Information
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NPI Number | 1245549237
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Entity Type | Organization
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Legal Business Name | RICHLAND DENTISTRY
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 8699 GULL RD
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City | RICHLAND
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State | MI
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Zip | 49083-9647
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Country | US
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Telephone | 269-629-9087
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Fax |
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Provider Business Mailing Address
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Address Line | 8699 GULL RD
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City | RICHLAND
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State | MI
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Zip | 49083-9647
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Country | US
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Telephone | 269-629-9087
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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. KAREN EMILY FAYLE
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Credential | D.D.S.
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Telephone | 269-629-9087
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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 | 2901012482
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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 | 2901020033
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901018833
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License Number State | MI
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