Provider Demographics
NPI:1740290949
Name:VINCENT I. STROCKIS, D.D.S. P.C.
Entity type:Organization
Organization Name:VINCENT I. STROCKIS, D.D.S. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:I
Authorized Official - Last Name:STROCKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-359-2629
Mailing Address - Street 1:7320 WOODSIDE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48450-8954
Mailing Address - Country:US
Mailing Address - Phone:810-359-2629
Mailing Address - Fax:
Practice Address - Street 1:35000 DIVISION RD
Practice Address - Street 2:SUITE 4
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-1566
Practice Address - Country:US
Practice Address - Phone:586-727-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010103691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty