Provider Demographics
NPI:1881819241
Name:GORSKI, TERESA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:A
Last Name:GORSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:GORSKI
Other - Last Name:SZEWCZYK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1668 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-5707
Mailing Address - Country:US
Mailing Address - Phone:248-816-9901
Mailing Address - Fax:248-269-6990
Practice Address - Street 1:7433 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48210-2227
Practice Address - Country:US
Practice Address - Phone:313-842-4255
Practice Address - Fax:313-842-1211
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIII0481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice