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General NPI Number Information
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NPI Number | 1881819241
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Entity Type | Individual
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Provider Name | TERESA A. GORSKI D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7433 MICHIGAN AVE
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City | DETROIT
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State | MI
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Zip | 48210-2227
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Country | US
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Telephone | 313-842-4255
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Fax | 313-842-1211
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Provider Business Mailing Address
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Address Line | 1668 LEXINGTON DR
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City | TROY
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State | MI
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Zip | 48084-5707
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Country | US
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Telephone | 248-816-9901
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Fax | 248-269-6990
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | II048
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License Number State | MI
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