Provider Demographics
NPI:1528218419
Name:ARDELEAN FAMILY DENTISTRY DDS, PC
Entity Type:Organization
Organization Name:ARDELEAN FAMILY DENTISTRY DDS, PC
Other - Org Name:ARDELEAN FAMILY & COSMETIC DENTISTRY, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:FLORICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARDELEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-465-4505
Mailing Address - Street 1:23935 DENTON ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3404
Mailing Address - Country:US
Mailing Address - Phone:586-465-4505
Mailing Address - Fax:586-465-4507
Practice Address - Street 1:23935 DENTON ST
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-3404
Practice Address - Country:US
Practice Address - Phone:586-465-4505
Practice Address - Fax:586-465-4507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty