MEDICARE: LISA S PAPSIN DMD PC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1700652377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LISA S PAPSIN DMD PC

Provider Business Mailing Address
First Line	:	4334 ARDMORE DR
Second Line	:
City	:	BLOOMFIELD TOWNSHIP
State	:	MI
Zip	:	48302-2104
Country	:	US
Telephone Number	:	248-229-3810
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 W MAPLE RD STE B
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-3308
Country	:	US
Telephone Number	:	248-651-0707
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	LISA PAPSIN
Credential	:	DMD
Telephone Number	:	248-229-3810

Provider Enumeration Date	:	11/27/2023
Last Update Date	:	11/27/2023

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