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General NPI Number Information
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NPI Number | 1396999264
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Entity Type | Organization
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Legal Business Name | PIESKO & LENNAN DDS, PC
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 15741 GRATIOT RD
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City | HEMLOCK
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State | MI
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Zip | 48626-8457
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Country | US
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Telephone | 989-642-2750
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Fax | 989-642-2746
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Provider Business Mailing Address
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Address Line | 15741 GRATIOT RD
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City | HEMLOCK
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State | MI
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Zip | 48626-8457
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Country | US
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Telephone | 989-642-2750
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Fax | 989-642-2746
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARIA LOU BIERLEIN
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Credential |
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Telephone | 989-652-6196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9779
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License Number State | MI
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