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General NPI Number Information
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NPI Number | 1285173807
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Entity Type | Organization
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Legal Business Name | PETER MICHAEL CARLIN
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 31290 23 MILE RD
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City | CHESTERFIELD
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State | MI
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Zip | 48047-1850
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Country | US
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Telephone | 586-949-0611
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Fax | 586-949-1714
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Provider Business Mailing Address
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Address Line | 31290 23 MILE RD
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City | CHESTERFIELD
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State | MI
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Zip | 48047-1850
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Country | US
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Telephone | 586-949-0611
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Fax | 586-949-1714
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER M CARLIN
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Credential | DDS
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Telephone | 586-949-0611
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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 | 2901014787
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License Number State | MI
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