Provider Demographics
NPI:1467673178
Name:ANDREW G. ARETAKIS, D.D.S,P.C.
Entity Type:Organization
Organization Name:ANDREW G. ARETAKIS, D.D.S,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:ARETAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-664-2235
Mailing Address - Street 1:1386 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1349
Mailing Address - Country:US
Mailing Address - Phone:810-664-2235
Mailing Address - Fax:810-664-8904
Practice Address - Street 1:1386 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1349
Practice Address - Country:US
Practice Address - Phone:810-664-2235
Practice Address - Fax:810-664-8904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010161371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty