Provider Demographics
NPI:1578737516
Name:MARC L. DWOSKIN, D.D.S., P.C.
Entity Type:Organization
Organization Name:MARC L. DWOSKIN, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PREVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-626-0772
Mailing Address - Street 1:32931 MIDDLEBELT RD
Mailing Address - Street 2:SUITE 608
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1772
Mailing Address - Country:US
Mailing Address - Phone:248-626-0772
Mailing Address - Fax:248-626-3572
Practice Address - Street 1:32931 MIDDLEBELT RD
Practice Address - Street 2:SUITE 608
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1772
Practice Address - Country:US
Practice Address - Phone:248-626-0772
Practice Address - Fax:248-626-3572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty