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General NPI Number Information
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NPI Number | 1366326936
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Entity Type | Organization
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Legal Business Name | DIRENZO DENTAL, PLLC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 2240 S HURON PKWY
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City | ANN ARBOR
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State | MI
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Zip | 48104-5151
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Country | US
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Telephone | 734-677-2156
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 S HURON PKWY
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City | ANN ARBOR
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State | MI
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Zip | 48104-5151
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KYLE DIRENZO
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Credential |
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Telephone | 540-454-7800
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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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