Provider Demographics
NPI:1194226902
Name:K FAMILY DENTISTRY PLLC
Entity Type:Organization
Organization Name:K FAMILY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURSHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-831-5313
Mailing Address - Street 1:3456 E 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-2511
Mailing Address - Country:US
Mailing Address - Phone:586-486-4600
Mailing Address - Fax:586-486-4624
Practice Address - Street 1:3456 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-2511
Practice Address - Country:US
Practice Address - Phone:586-486-4600
Practice Address - Fax:586-486-4624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty