Provider Demographics
NPI:1265830459
Name:VERNOR DENTAL, P.C.
Entity Type:Organization
Organization Name:VERNOR DENTAL, P.C.
Other - Org Name:VERNOR FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-755-5700
Mailing Address - Street 1:23800 ORCHARD LAKE RD
Mailing Address - Street 2:STE. 106
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2560
Mailing Address - Country:US
Mailing Address - Phone:248-755-5700
Mailing Address - Fax:
Practice Address - Street 1:10033 VERNOR HWY
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1513
Practice Address - Country:US
Practice Address - Phone:313-843-6530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-21
Last Update Date:2014-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty