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General NPI Number Information
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NPI Number | 1407440399
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Entity Type | Organization
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Legal Business Name | NEW YOU DENTAL MANAGEMENT- LANSING
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 3201 E GRAND RIVER AVE
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City | LANSING
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State | MI
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Zip | 48912-4749
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Country | US
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Telephone | 248-595-0161
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Fax |
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Provider Business Mailing Address
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Address Line | 23225 NORTHWESTERN HWY
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City | SOUTHFIELD
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State | MI
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Zip | 48075-7707
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Country | US
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Telephone | 248-595-0161
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Fax | 248-281-5128
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | JANE PAISOPOULOS
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Credential | COO
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Telephone | 248-595-0161
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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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