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General NPI Number Information
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NPI Number | 1770701286
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Entity Type | Organization
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Legal Business Name | BRIAN J DONLON D D S P C
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Dates
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Enumeration Date | 04/22/2007
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 44710 VAN DYKE AVE
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City | UTICA
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State | MI
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Zip | 48317-5482
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Country | US
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Telephone | 586-739-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 44710 VAN DYKE AVE
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City | UTICA
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State | MI
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Zip | 48317-5482
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Country | US
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Telephone | 586-739-0550
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. BRIAN DONLON
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Credential |
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Telephone | 586-739-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | AD5435309
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License Number State | MI
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