Provider Demographics
NPI:1093023442
Name:YPSILANTI FAMILY DENTAL P.C
Entity Type:Organization
Organization Name:YPSILANTI FAMILY DENTAL P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:REGINALD
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-482-3500
Mailing Address - Street 1:127 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2619
Mailing Address - Country:US
Mailing Address - Phone:734-782-3500
Mailing Address - Fax:734-428-3248
Practice Address - Street 1:127 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2619
Practice Address - Country:US
Practice Address - Phone:734-782-3500
Practice Address - Fax:734-428-3248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI166181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty