MEDICARE: A & N DENTAL GROUP, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901019402	MI
2	122300000X	Dentist	2901019678	MI

General Provider Information

NPI Number	:	1306011549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A & N DENTAL GROUP, P.C.

Provider Business Mailing Address
First Line	:	23700 ORCHARD LAKE RD
Second Line	:	SUITE J
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2559
Country	:	US
Telephone Number	:	248-478-0831
Fax Number	:

Provider Business Practice Location Address
First Line	:	23700 ORCHARD LAKE RD
Second Line	:	SUITE J
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2559
Country	:	US
Telephone Number	:	248-478-0831
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MELODY D. MINSTER
Credential	:	C.D.A.
Telephone Number	:	248-478-0831

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	04/29/2008

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