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General NPI Number Information
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NPI Number | 1912241795
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Entity Type | Organization
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Legal Business Name | KELLY M. GIERA, D.D.S., P.C.
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 650 E BIG BEAVER RD SUITE D
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City | TROY
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State | MI
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Zip | 48083-1432
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Country | US
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Telephone | 248-528-2270
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Fax |
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Provider Business Mailing Address
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Address Line | 650 E BIG BEAVER RD SUITE D
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City | TROY
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State | MI
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Zip | 48083-1432
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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 | OWNER
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Name | DR. KELLY M GIERA
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Credential | DDS
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Telephone | 248-528-2270
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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 |
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License Number State |
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