Provider Demographics
NPI:1053042705
Name:JOHN E. GEORGE, D.D.S., P.C.
Entity Type:Organization
Organization Name:JOHN E. GEORGE, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-566-1150
Mailing Address - Street 1:15298 WELLINGTON CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-3536
Mailing Address - Country:US
Mailing Address - Phone:586-566-1150
Mailing Address - Fax:586-261-0148
Practice Address - Street 1:15298 WELLINGTON CENTER BLVD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-3536
Practice Address - Country:US
Practice Address - Phone:586-566-1150
Practice Address - Fax:586-261-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental