MEDICARE: METROPOLITAN DENTAL CENTER OF WATERFORD 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	122300000X	Dentist

General Provider Information

NPI Number	:	1790851970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METROPOLITAN DENTAL CENTER OF WATERFORD PC

Provider Business Mailing Address
First Line	:	4664 W WALTON BLVD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48329-3537
Country	:	US
Telephone Number	:	248-674-0418
Fax Number	:	248-674-4518

Provider Business Practice Location Address
First Line	:	4664 W WALTON BLVD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48329-3537
Country	:	US
Telephone Number	:	248-674-0418
Fax Number	:	248-674-4518

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY S INGBER
Credential	:	DDS
Telephone Number	:	248-674-0418

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	11/10/2025

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