Provider Demographics
NPI:1689194227
Name:CALEK, MARY HANNAWA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:HANNAWA
Last Name:CALEK
Suffix:
Gender:F
Credentials:DDS
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Other - Credentials:
Mailing Address - Street 1:5432 PROVINCIAL DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2539
Mailing Address - Country:US
Mailing Address - Phone:248-755-1542
Mailing Address - Fax:
Practice Address - Street 1:2240 LIVERNOIS RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1664
Practice Address - Country:US
Practice Address - Phone:248-528-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-25
Last Update Date:2023-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI29010222501223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry