Provider Demographics
NPI:1306011549
Name:A & N DENTAL GROUP, P.C.
Entity Type:Organization
Organization Name:A & N DENTAL GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MINSTER
Authorized Official - Suffix:
Authorized Official - Credentials:CDA
Authorized Official - Phone:248-478-0831
Mailing Address - Street 1:23700 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2559
Mailing Address - Country:US
Mailing Address - Phone:248-478-0831
Mailing Address - Fax:
Practice Address - Street 1:23700 ORCHARD LAKE RD
Practice Address - Street 2:SUITE J
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2559
Practice Address - Country:US
Practice Address - Phone:248-478-0831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019678122300000X
MI2901019402122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty