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General NPI Number Information
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NPI Number | 1336396167
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Entity Type | Individual
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Provider Name | NANCY ELIZABETH HARTRICK D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 08/22/2008
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Provider Practice Location Address
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Address Line | 32609 WOODWARD AVE
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City | ROYAL OAK
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State | MI
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Zip | 48073-0952
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Country | US
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Telephone | 248-549-0950
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Fax | 248-549-1180
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Provider Business Mailing Address
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Address Line | 32609 WOODWARD AVE
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City | ROYAL OAK
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State | MI
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Zip | 48073-0952
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Country | US
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Telephone | 248-549-0950
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Fax | 248-549-1180
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12800
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License Number State | MI
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