Provider Demographics
NPI:1114166626
Name:SINAR, GARY JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:JOHN
Last Name:SINAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29425 W 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4113
Mailing Address - Country:US
Mailing Address - Phone:248-474-6993
Mailing Address - Fax:248-474-6994
Practice Address - Street 1:29425 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4113
Practice Address - Country:US
Practice Address - Phone:248-474-6993
Practice Address - Fax:248-474-6994
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11956122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist