Dellavecchia Dental Services, P.C.
Organization Active NPI Dental Clinic/Center · Douglas, MI
NPI 1982836714 · NPPES record last updated Aug 12, 2009
Key facts
- NPI
- 1982836714
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- License
- 2901018649 (MI)
- Legal business name
- DELLAVECCHIA DENTAL SERVICES, P.C.
- Practice address
- 430 130TH Ave
Douglas, MI 49406-5100 - Phone
- (269) 857-1431
- Fax
- (269) 857-4089
- NPI assigned
- Aug 12, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Tracey Jean Dellavecchia, D.D.S.
- Title
- Dentist/Owner
- Phone
- (269) 857-1431
Practitioners 1
-
Tracey Jean Dellavecchia, D.D.S.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 2901018649 | MI | Yes |
Addresses
Primary practice location
430 130TH Ave
Douglas, MI 49406-5100
Mailing address
430 130TH Ave
Douglas, MI 49406-5100
Phone (269) 857-1431
Other providers in Douglas, MI
- Richard C. Annis III
- Jennae C Blattner
- Cresco Counseling
- Shelley Ann Defouw
- Tracey Jean Dellavecchia
- Douglas Cove Mi Opco LLC
- Douglas Investments & Associates, LLC
- Douglas Mi Opco LLC
- Focus Point Behavioral Health, PLLC
All providers in Douglas, MI · Dental Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2009. 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.