Provider Demographics
NPI:1396999264
Name:PIESKO & LENNAN DDS, PC
Entity type:Organization
Organization Name:PIESKO & LENNAN DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:BIERLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-652-6196
Mailing Address - Street 1:15741 GRATIOT RD
Mailing Address - Street 2:
Mailing Address - City:HEMLOCK
Mailing Address - State:MI
Mailing Address - Zip Code:48626-8457
Mailing Address - Country:US
Mailing Address - Phone:989-642-2750
Mailing Address - Fax:989-642-2746
Practice Address - Street 1:15741 GRATIOT RD
Practice Address - Street 2:
Practice Address - City:HEMLOCK
Practice Address - State:MI
Practice Address - Zip Code:48626-8457
Practice Address - Country:US
Practice Address - Phone:989-642-2750
Practice Address - Fax:989-642-2746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI9779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty