Provider Demographics
NPI:1851408892
Name:DRS DELANEY PLUNKETT RALSTROM MAKOWSKI THANASAS
Entity Type:Organization
Organization Name:DRS DELANEY PLUNKETT RALSTROM MAKOWSKI THANASAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JOELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-286-0700
Mailing Address - Street 1:39400 GARFIELD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-4096
Mailing Address - Country:US
Mailing Address - Phone:586-286-0700
Mailing Address - Fax:586-286-5969
Practice Address - Street 1:39400 GARFIELD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-4096
Practice Address - Country:US
Practice Address - Phone:586-286-0700
Practice Address - Fax:586-286-5969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty