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General NPI Number Information
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NPI Number | 1437892031
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Entity Type | Organization
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Legal Business Name | MAUREEN M GIERUCKI DDS PLLC
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 780 W SPRUCE ST # 636
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City | HARRISON
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State | MI
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Zip | 48625-9400
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Country | US
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Telephone | 989-539-2146
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Fax | 989-539-9958
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Provider Business Mailing Address
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Address Line | 780 W SPRUCE ST # 636
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City | HARRISON
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State | MI
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Zip | 48625-9400
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Country | US
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Telephone | 989-539-2146
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Fax | 989-539-9958
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Authorized Official
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Title or Position | OWNER
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Name | MAUREEN GIERUCKI
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Credential | DDS
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Telephone | 313-980-9744
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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 |
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License Number State |
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