Provider Demographics
NPI:1003403890
Name:AMANDA REMER-CHANG, DDS, PLLC
Entity Type:Organization
Organization Name:AMANDA REMER-CHANG, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:HILARY
Authorized Official - Last Name:REMER-CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-417-2870
Mailing Address - Street 1:2828 FERRIS ST
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-2167
Mailing Address - Country:US
Mailing Address - Phone:248-417-2870
Mailing Address - Fax:
Practice Address - Street 1:201 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-2679
Practice Address - Country:US
Practice Address - Phone:248-348-6780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty