Provider Demographics
NPI:1558932178
Name:TREMONTI, CHELSEA (DDS)
Entity Type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:
Last Name:TREMONTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 SEVERN RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1944
Mailing Address - Country:US
Mailing Address - Phone:313-452-5883
Mailing Address - Fax:
Practice Address - Street 1:40105 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2170
Practice Address - Country:US
Practice Address - Phone:248-471-0345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600932122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist