Provider Demographics
NPI:1619561503
Name:NEW YOU DENTAL MANAGEMENT- SOUTHFIELD
Entity Type:Organization
Organization Name:NEW YOU DENTAL MANAGEMENT- SOUTHFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAISOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:248-595-0161
Mailing Address - Street 1:23225 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-7707
Mailing Address - Country:US
Mailing Address - Phone:248-595-0161
Mailing Address - Fax:248-281-5128
Practice Address - Street 1:30555 SOUTHFIELD RD STE 310
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-7752
Practice Address - Country:US
Practice Address - Phone:248-595-0161
Practice Address - Fax:248-281-5128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental