Provider Demographics
NPI:1639637721
Name:FIENMAN DENTAL PLLC
Entity Type:Organization
Organization Name:FIENMAN DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FIENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-539-3600
Mailing Address - Street 1:5813 W MAPLE RD STE 131
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4400
Mailing Address - Country:US
Mailing Address - Phone:248-539-3600
Mailing Address - Fax:
Practice Address - Street 1:5813 W MAPLE RD STE 131
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4400
Practice Address - Country:US
Practice Address - Phone:248-539-3600
Practice Address - Fax:248-539-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental