Provider Demographics
NPI:1598409500
Name:ANU MANGAL DDS, PC
Entity Type:Organization
Organization Name:ANU MANGAL DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANU
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-979-3200
Mailing Address - Street 1:4151 17 MILE RD STE F
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-6866
Mailing Address - Country:US
Mailing Address - Phone:586-979-3200
Mailing Address - Fax:586-979-3226
Practice Address - Street 1:4151 17 MILE RD STE F
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-6866
Practice Address - Country:US
Practice Address - Phone:586-979-3200
Practice Address - Fax:586-979-3226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental