Provider Demographics
NPI:1336845411
Name:MICHIGAN FAMILY AND COSMETIC DENTISTRY
Entity Type:Organization
Organization Name:MICHIGAN FAMILY AND COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:KATYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-341-5330
Mailing Address - Street 1:4893 ROCHESTER RD STE C
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-4971
Mailing Address - Country:US
Mailing Address - Phone:248-341-5330
Mailing Address - Fax:248-341-5340
Practice Address - Street 1:4893 ROCHESTER RD STE C
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-4971
Practice Address - Country:US
Practice Address - Phone:248-341-5330
Practice Address - Fax:248-341-5340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental