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General NPI Number Information
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NPI Number | 1841440245
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Entity Type | Organization
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Legal Business Name | PEARL DENTAL P.C.
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 33566 W 8 MILE RD STE B
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-5271
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Country | US
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Telephone | 248-476-4416
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Fax | 248-679-8889
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Provider Business Mailing Address
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Address Line | 50364 LIVINGSTON DR
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City | NORTHVILLE
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State | MI
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Zip | 48168-6802
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Country | US
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Telephone | 248-476-4416
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Fax | 248-679-8889
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHETANA D KARANTH
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Credential | DDS
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Telephone | 248-476-4416
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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 |
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License Number State |
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