Provider Demographics
NPI:1235406497
Name:IN-HOME DENTAL CARE, INC.
Entity Type:Organization
Organization Name:IN-HOME DENTAL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ARMATIS
Authorized Official - Suffix:
Authorized Official - Credentials:RDH, BS
Authorized Official - Phone:734-330-1562
Mailing Address - Street 1:1495 FORT ST
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-3036
Mailing Address - Country:US
Mailing Address - Phone:734-330-1562
Mailing Address - Fax:
Practice Address - Street 1:1600 PINETREE DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-1754
Practice Address - Country:US
Practice Address - Phone:734-330-1562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902013865124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty