Provider Demographics
NPI:1801408463
Name:PELC, ALEC HOUSE (DDS)
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:HOUSE
Last Name:PELC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7339 DONEGAL DR
Mailing Address - Street 2:
Mailing Address - City:ONSTED
Mailing Address - State:MI
Mailing Address - Zip Code:49265-9622
Mailing Address - Country:US
Mailing Address - Phone:248-931-2362
Mailing Address - Fax:
Practice Address - Street 1:33428 FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-2860
Practice Address - Country:US
Practice Address - Phone:734-427-7555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016005961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice