Provider Demographics
NPI:1013614882
Name:BIRMINGHAM DENTAL
Entity Type:Organization
Organization Name:BIRMINGHAM DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUDNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-645-2710
Mailing Address - Street 1:2151 E 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-7260
Mailing Address - Country:US
Mailing Address - Phone:248-645-2710
Mailing Address - Fax:248-645-5283
Practice Address - Street 1:2151 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-7260
Practice Address - Country:US
Practice Address - Phone:248-645-2710
Practice Address - Fax:248-645-5283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty