Provider Demographics
NPI:1558854356
Name:APPIAGYEI, AKOSUA S (DDS)
Entity Type:Individual
Prefix:
First Name:AKOSUA
Middle Name:S
Last Name:APPIAGYEI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:AKOSUA
Other - Middle Name:S
Other - Last Name:MENSAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 865
Mailing Address - Street 2:
Mailing Address - City:WHITE CLOUD
Mailing Address - State:MI
Mailing Address - Zip Code:49349-0865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1615 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:MI
Practice Address - Zip Code:49304-7984
Practice Address - Country:US
Practice Address - Phone:231-745-2736
Practice Address - Fax:231-745-5050
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010226501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2901022650OtherMICHIGAN STATE LICENSE NUMBER