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General NPI Number Information
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NPI Number | 1487343133
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Entity Type | Organization
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Legal Business Name | TOOTH AND WAFFLES, PLLC
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 40053 8 MILE RD STE 200
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City | NORTHVILLE
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State | MI
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Zip | 48167-1954
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Country | US
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Telephone | 248-444-6223
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Fax | 248-710-2209
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Provider Business Mailing Address
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Address Line | 1104 PARK PLACE COURT
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302
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Country | US
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Telephone | 412-327-9193
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANNY KALASH
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Credential | DMD, MPH
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Telephone | 248-444-6223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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