Provider Demographics
NPI:1952443152
Name:ACLERNO, DENISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:ACLERNO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 W 5TH STREET
Mailing Address - Street 2:SUITE #100
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2545
Mailing Address - Country:US
Mailing Address - Phone:248-548-6365
Mailing Address - Fax:248-548-6372
Practice Address - Street 1:424 W 5TH STREET
Practice Address - Street 2:SUITE #100
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2545
Practice Address - Country:US
Practice Address - Phone:248-548-6365
Practice Address - Fax:248-548-6372
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI13678941223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
O17559Medicare UPIN