Provider Demographics
NPI:1467626093
Name:J. E. GHILZON DDS, PLLC
Entity Type:Organization
Organization Name:J. E. GHILZON DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:GHILZON
Authorized Official - Suffix:
Authorized Official - Credentials:BS DDS MS
Authorized Official - Phone:586-731-9686
Mailing Address - Street 1:50706 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-1363
Mailing Address - Country:US
Mailing Address - Phone:586-731-9686
Mailing Address - Fax:586-731-9799
Practice Address - Street 1:50706 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-1363
Practice Address - Country:US
Practice Address - Phone:586-731-9686
Practice Address - Fax:586-731-9799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental