Provider Demographics
NPI:1114320058
Name:DAILY DENTAL CENTER
Entity Type:Organization
Organization Name:DAILY DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WEI
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-846-1788
Mailing Address - Street 1:905 W EISENHOWER CIR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6400
Mailing Address - Country:US
Mailing Address - Phone:734-997-8805
Mailing Address - Fax:888-275-5508
Practice Address - Street 1:905 W EISENHOWER CIR
Practice Address - Street 2:SUITE 105
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6400
Practice Address - Country:US
Practice Address - Phone:734-997-8805
Practice Address - Fax:888-275-5508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI202591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI20259OtherSTATE DENTIST LICENSE