A Dental Center-Downriver

Organization Active NPI Point of Service · Riverview, MI

NPI 1528064771 · NPPES record last updated Sep 5, 2007

Key facts

NPI
1528064771
Entity type
Organization (NPI type 2)
Primary specialty
Point of Service 305S00000X
License
17288 (MI)
Legal business name
A DENTAL CENTER-DOWNRIVER
Practice address
17128 Fort St
Riverview, MI 48193-6619
Phone
(734) 281-3200
Fax
(734) 281-3890
NPI assigned
Jun 22, 2005
Organization subpart
No

Authorized official

Name
Dr. Howard Potocsky, D.D.S
Title
Billing
Phone
(734) 281-3200

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 17288 MI Yes

Addresses

Primary practice location

17128 Fort St
Riverview, MI 48193-6619

Mailing address

17128 Fort St
Riverview, MI 48193-6619
Phone (734) 281-3200

Other identifiers

IdentifierTypeStateIssuer
D172880OtherMIBLUE CROSS BLUE SHIELD

Other providers in Riverview, MI

All providers in Riverview, MI · Point of Service in Michigan

Sources for this page

Verify at the official NPI Registry.