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General NPI Number Information
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NPI Number | 1518017789
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Entity Type | Organization
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Legal Business Name | ESPECIALLY FOR KIDS, P.C.
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 25811 W 12 MILE RD SUITE 202
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City | SOUTHFIELD
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State | MI
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Zip | 48034
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Country | US
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Telephone | 248-559-5554
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Fax | 248-559-3114
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Provider Business Mailing Address
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Address Line | 25811 W. 12 MILE RD SUITE 202
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City | SOUTHFIELD
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State | MI
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Zip | 48034
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Country | US
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Telephone | 248-559-5554
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Fax | 248-559-3114
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. ANGELA M ROGERS
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Credential | DMD,MS
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Telephone | 248-559-5554
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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 | 13198
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License Number State | MI
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