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General NPI Number Information
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NPI Number | 1578529681
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Entity Type | Organization
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Legal Business Name | TRI-COUNTY PAIN CONSULTANTS PC
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 11/19/2008
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Provider Practice Location Address
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Address Line | 26850 PROVIDENCE PKWY SUITE 260
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City | NOVI
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State | MI
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Zip | 48374-1213
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Country | US
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Telephone | 248-735-8272
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Fax | 248-735-7276
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Provider Business Mailing Address
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Address Line | 61 COMMERCE AVE SW
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4124
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Country | US
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Telephone | 616-940-0660
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Fax | 616-940-1965
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENNIS WILLIAM DOBRITT
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Credential | DO
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Telephone | 248-626-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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