Provider Demographics
NPI:1639225923
Name:FLOYD, TRINA
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4085 S. CENTER RD.
Mailing Address - Street 2:SUITE #2
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519
Mailing Address - Country:US
Mailing Address - Phone:810-742-4320
Mailing Address - Fax:810-742-8482
Practice Address - Street 1:4085 S. CENTER RD.
Practice Address - Street 2:SUITE #2
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48519
Practice Address - Country:US
Practice Address - Phone:810-742-4320
Practice Address - Fax:810-742-8482
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010128011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice