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General NPI Number Information
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NPI Number | 1598235582
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Entity Type | Organization
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Legal Business Name | ENDODONTIC ASSOCIATES OF MICHIGAN PLLC
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Dates
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Enumeration Date | 12/03/2018
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 25500 MEADOWBROOK STE. 125
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City | NOVI
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State | MI
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Zip | 48375
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Country | US
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Telephone | 248-427-0488
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Fax | 248-427-0588
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Provider Business Mailing Address
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Address Line | 25500 MEADOWBROOK STE. 125
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City | NOVI
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State | MI
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Zip | 48375
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Country | US
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Telephone | 248-427-0488
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Fax | 248-427-0588
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Authorized Official
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Title or Position | PARTNER DOCTOR
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Name | DR. GERALD C DIETZ
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Credential | DDS
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Telephone | 248-647-0186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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