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General NPI Number Information
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NPI Number | 1730256710
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Entity Type | Organization
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Legal Business Name | THE SCHOOL DENTIST, P.C.
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 31731 ARLINGTON DR
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-5663
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Country | US
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Telephone | 248-646-1381
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Fax |
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Provider Business Mailing Address
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Address Line | 31731 ARLINGTON DR
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-5663
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MELANIE SHEILS VERGELDT
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Credential | DDS
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Telephone | 248-646-1381
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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 | 16594
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License Number State | MI
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