Royal Oak Family Dentistry

Organization Active NPI General Practice Dentistry · Pleasant Ridge, MI

NPI 1417907312 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1417907312
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
ROYAL OAK FAMILY DENTISTRY
Practice address
28 Oakland Park Blvd
Pleasant Ridge, MI 48069-1109
Phone
(248) 543-7070
Fax
(248) 543-3520
NPI assigned
May 11, 2006
Organization subpart
No

Authorized official

Name
Mr. Daniel Gergory Costello
Title
Office Manager
Phone
(248) 543-7070

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Royal Oak Family Dentistry (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

28 Oakland Park Blvd
Pleasant Ridge, MI 48069-1109

Mailing address

1200 S Washington Ave
Royal Oak, MI 48067-3222
Phone (248) 543-7070

Other providers in Pleasant Ridge, MI

All providers in Pleasant Ridge, MI · General Practice Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.