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General NPI Number Information
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NPI Number | 1437456548
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Entity Type | Organization
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Legal Business Name | GWYNNE ATTARIAN DDS PLLC
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 02/25/2011
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Provider Practice Location Address
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Address Line | 8641 W GRAND RIVER AVE SUITE 3
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City | BRIGHTON
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State | MI
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Zip | 48116-4353
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Country | US
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Telephone | 810-360-0330
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Fax | 810-229-2965
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Provider Business Mailing Address
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Address Line | 8641 W GRAND RIVER AVE SUITE 3
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City | BRIGHTON
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State | MI
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Zip | 48116-4353
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Country | US
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Telephone | 810-360-0330
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Fax | 810-229-2965
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Authorized Official
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Title or Position | OWNER
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Name | GWYNNE ATTARIAN
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Credential | DDS
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Telephone | 810-360-0330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901017918
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License Number State | MI
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