Provider Demographics
NPI:1871189423
Name:DOWNTOWN DENTAL STUDIO, PLLC
Entity Type:Organization
Organization Name:DOWNTOWN DENTAL STUDIO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATWE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-880-2445
Mailing Address - Street 1:107 E WASHTENAW ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48933-1822
Mailing Address - Country:US
Mailing Address - Phone:517-487-5666
Mailing Address - Fax:
Practice Address - Street 1:107 E WASHTENAW ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48933-1822
Practice Address - Country:US
Practice Address - Phone:517-487-5666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental