Provider Demographics
NPI:1881866200
Name:WEST, DENNIS MICHAEL (DMD DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:WEST
Suffix:
Gender:M
Credentials:DMD DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 TELEGRAPH RD
Mailing Address - Street 2:#F3
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48301
Mailing Address - Country:US
Mailing Address - Phone:248-647-2860
Mailing Address - Fax:248-647-0183
Practice Address - Street 1:6405 TELEGRAPH RD
Practice Address - Street 2:#F3
Practice Address - City:BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48301
Practice Address - Country:US
Practice Address - Phone:248-647-2860
Practice Address - Fax:248-647-0183
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI014965122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist