Provider Demographics
NPI:1205009263
Name:BAKER COLLEGE OF AUBURN HILLS
Entity Type:Organization
Organization Name:BAKER COLLEGE OF AUBURN HILLS
Other - Org Name:DENTAL DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT DEAN OF DENTAL HYGIENE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:RDH, MS
Authorized Official - Phone:248-276-8881
Mailing Address - Street 1:1500 UNIVERSITY DR
Mailing Address - Street 2:DENTAL DEPARTMENT
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2642
Mailing Address - Country:US
Mailing Address - Phone:248-276-6664
Mailing Address - Fax:248-276-2521
Practice Address - Street 1:1500 UNIVERSITY DR
Practice Address - Street 2:DENTAL DEPARTMENT
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2642
Practice Address - Country:US
Practice Address - Phone:248-276-6664
Practice Address - Fax:248-276-2521
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAKER COLLEGE OF AUBURN HILLS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty