Provider Demographics
NPI:1235105008
Name:DENTISTRY FOR CHILDREN PC
Entity Type:Organization
Organization Name:DENTISTRY FOR CHILDREN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTORO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-479-2222
Mailing Address - Street 1:14525 SIBLEY RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7756
Mailing Address - Country:US
Mailing Address - Phone:734-479-2222
Mailing Address - Fax:734-479-2122
Practice Address - Street 1:14525 SIBLEY RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193-7756
Practice Address - Country:US
Practice Address - Phone:734-479-2222
Practice Address - Fax:734-479-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010117331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty