Provider Demographics
NPI:1417137852
Name:JUERGEN LAFRENZ DDS PLC
Entity Type:Organization
Organization Name:JUERGEN LAFRENZ DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUERGEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFRENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-412-7100
Mailing Address - Street 1:43230 GARFIELD RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1164
Mailing Address - Country:US
Mailing Address - Phone:586-412-7100
Mailing Address - Fax:586-412-7105
Practice Address - Street 1:43230 GARFIELD RD
Practice Address - Street 2:SUITE 110
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1162
Practice Address - Country:US
Practice Address - Phone:586-412-7100
Practice Address - Fax:586-412-7105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI119121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty