Provider Demographics
NPI:1750166237
Name:PSDENTISTRY PLLC
Entity type:Organization
Organization Name:PSDENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TEJAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-292-7031
Mailing Address - Street 1:2025 SACHIN WAY
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3338
Mailing Address - Country:US
Mailing Address - Phone:586-292-7031
Mailing Address - Fax:
Practice Address - Street 1:46671 HAYES RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-5506
Practice Address - Country:US
Practice Address - Phone:586-292-7031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental