Provider Demographics
NPI:1609957646
Name:CAMBRIDGE DENTAL CENTER, P.C.
Entity Type:Organization
Organization Name:CAMBRIDGE DENTAL CENTER, P.C.
Other - Org Name:CAMBRIDGE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SKLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-274-4040
Mailing Address - Street 1:27281 W WARREN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1804
Mailing Address - Country:US
Mailing Address - Phone:313-274-4040
Mailing Address - Fax:313-274-8080
Practice Address - Street 1:27281 W WARREN ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1804
Practice Address - Country:US
Practice Address - Phone:313-274-4040
Practice Address - Fax:313-274-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010141391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty