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General NPI Number Information
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NPI Number | 1336794908
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Entity Type | Organization
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Legal Business Name | JOHNSON AND VARSANIK, PLLC
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Dates
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Enumeration Date | 08/09/2019
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Last Update Date | 08/09/2019
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Provider Practice Location Address
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Address Line | 1460 WALTON BLVD SUITE 205
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-4843
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Country | US
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Telephone | 734-347-2042
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Fax |
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Provider Business Mailing Address
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Address Line | 5347 CRYSTAL CREEK LN
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City | WASHINGTON
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State | MI
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Zip | 48094-2674
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Country | US
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Telephone | 810-516-3482
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. EMILY R VARSANIK
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Credential | DDS
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Telephone | 734-347-2042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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