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General NPI Number Information
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NPI Number | 1306032511
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Entity Type | Organization
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Legal Business Name | NORTH OAKLAND DENTAL CENTER
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 35 S JOHNSON ST SUITE 2A
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City | PONTIAC
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State | MI
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Zip | 48341-1658
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Country | US
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Telephone | 248-333-2424
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Fax | 248-623-1252
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Provider Business Mailing Address
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Address Line | 35 S JOHNSON ST SUITE 2A
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City | PONTIAC
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State | MI
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Zip | 48341-1658
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Country | US
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Telephone | 248-333-2424
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Fax | 248-623-1252
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD THOMAS MCDONALD
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Credential | D.D.S.
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Telephone | 248-333-2424
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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 | 2901007892
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License Number State | MI
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