Tymon C Totte
Individual provider Active NPI Dentist · Gross Pointe, MI
NPI 1184845844 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184845844
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2901018712 (MI)
- Practice address
- 17700 Mack Ave
Great Expressions Dental Centers
Gross Pointe, MI 48224 - Phone
- (313) 882-2211
- Fax
- (313) 882-5434
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901018712 | MI | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901018712 | MI | Yes |
Addresses
Primary practice location
17700 Mack Ave
Great Expressions Dental Centers
Gross Pointe, MI 48224
Mailing address
300 E Long Lake Rd
Ste 311
Bloomfield Hills, MI 48304
Phone (248) 203-1119
Other providers in Gross Pointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.