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General NPI Number Information
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NPI Number | 1427345925
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Entity Type | Individual
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Provider Name | ROXANNE DENISE PRYOR D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 07/05/2011
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Provider Practice Location Address
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Address Line | 13524 GARFIELD
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City | REDFORD
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State | MI
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Zip | 48239-4513
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Country | US
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Telephone | 313-595-7806
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 HAMTRAMCK DR
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City | HAMTRAMCK
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State | MI
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Zip | 48211-1400
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Country | US
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Telephone | 313-875-4386
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Fax | 313-875-9160
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901016395
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License Number State | MI
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