MEDICARE: DR. CYNTHIA ANN PRIEUR D.D.S.

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	1223G0001X	General Practice Dentistry	2901014126	MI

General Provider Information

NPI Number	:	1740555408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA ANN PRIEUR D.D.S.

Provider Business Mailing Address
First Line	:	42450 GARFIELD RD
Second Line	:	SUITE C
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5040
Country	:	US
Telephone Number	:	586-263-4140
Fax Number	:

Provider Business Practice Location Address
First Line	:	42450 GARFIELD RD
Second Line	:	SUITE C
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5040
Country	:	US
Telephone Number	:	586-263-4140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2012
Last Update Date	:	03/14/2012

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