Provider Demographics
NPI:1023199072
Name:ALGENIO, GENRUNDYNE C (DDS,PLLC)
Entity Type:Individual
Prefix:DR
First Name:GENRUNDYNE
Middle Name:C
Last Name:ALGENIO
Suffix:
Gender:F
Credentials:DDS,PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41400 DEQUINDRE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-3763
Mailing Address - Country:US
Mailing Address - Phone:586-803-9999
Mailing Address - Fax:586-991-0152
Practice Address - Street 1:41400 DEQUINDRE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-3763
Practice Address - Country:US
Practice Address - Phone:586-803-9999
Practice Address - Fax:586-991-0152
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI171791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice