Provider Demographics
NPI:1417263120
Name:METRO IMAGING CENTER PLC
Entity Type:Organization
Organization Name:METRO IMAGING CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:S
Authorized Official - Last Name:INGBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-674-0418
Mailing Address - Street 1:4664 W. WALTON BLVD.
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329
Mailing Address - Country:US
Mailing Address - Phone:248-674-0418
Mailing Address - Fax:248-674-4518
Practice Address - Street 1:4664 W. WALTON BLVD.
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329
Practice Address - Country:US
Practice Address - Phone:248-674-0418
Practice Address - Fax:248-674-4518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI9846122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty