Provider Demographics
NPI:1720751423
Name:RECCA PURI DDS, PLLC
Entity Type:Organization
Organization Name:RECCA PURI DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:RECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:PURI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-703-6937
Mailing Address - Street 1:8339 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-9285
Mailing Address - Country:US
Mailing Address - Phone:734-847-1955
Mailing Address - Fax:734-847-4394
Practice Address - Street 1:8339 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-9285
Practice Address - Country:US
Practice Address - Phone:734-847-1955
Practice Address - Fax:734-847-4394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty