Provider Demographics
NPI:1336434745
Name:NEW YOU DENTAL MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:NEW YOU DENTAL MANAGEMENT SERVICES
Other - Org Name:NEW YOU DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAISOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-799-7070
Mailing Address - Street 1:23225 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-7707
Mailing Address - Country:US
Mailing Address - Phone:248-799-7070
Mailing Address - Fax:248-416-1048
Practice Address - Street 1:4307 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1276
Practice Address - Country:US
Practice Address - Phone:810-733-7777
Practice Address - Fax:248-416-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010161981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty