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
National Provider Directory
- Tax ID family
- Royal Oak Family Dentistry
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
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
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.