Provider Demographics
NPI:1437327442
Name:AMRU ALBEIRUTI DDS PLC
Entity Type:Organization
Organization Name:AMRU ALBEIRUTI DDS PLC
Other - Org Name:ADA HILLS FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMRU
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBEIRUTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:616-676-1800
Mailing Address - Street 1:6739 FULTON ST E STE D-20
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-8138
Mailing Address - Country:US
Mailing Address - Phone:616-676-1800
Mailing Address - Fax:616-676-1801
Practice Address - Street 1:6739 FULTON ST E STE D-20
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-8138
Practice Address - Country:US
Practice Address - Phone:616-676-1800
Practice Address - Fax:616-676-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018631122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty