Provider Demographics
NPI:1477727188
Name:POWELL AND UDRYS DDS PC
Entity Type:Organization
Organization Name:POWELL AND UDRYS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GYTIS
Authorized Official - Middle Name:RIKANTAS
Authorized Official - Last Name:UDRYS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-429-2522
Mailing Address - Street 1:1101 N ANN ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-2000
Mailing Address - Country:US
Mailing Address - Phone:734-429-2522
Mailing Address - Fax:734-429-7055
Practice Address - Street 1:1101 N ANN ARBOR ST
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-2000
Practice Address - Country:US
Practice Address - Phone:734-429-2522
Practice Address - Fax:734-429-7055
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 Licenses
StateLicense IDTaxonomies
MI2901017298122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty