Provider Demographics
NPI:1467675421
Name:A 1 DENTAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:A 1 DENTAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-283-4648
Mailing Address - Street 1:20302 EUREKA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-5310
Mailing Address - Country:US
Mailing Address - Phone:734-283-4648
Mailing Address - Fax:734-283-5863
Practice Address - Street 1:20302 EUREKA RD
Practice Address - Street 2:SUITE B
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5310
Practice Address - Country:US
Practice Address - Phone:734-283-4648
Practice Address - Fax:734-283-5863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty