Provider Demographics
NPI:1770706715
Name:FLAT ROCK DENTAL, P.C.
Entity type:Organization
Organization Name:FLAT ROCK DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-782-3500
Mailing Address - Street 1:26500 W HURON RIVER DR
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:MI
Mailing Address - Zip Code:48134-1135
Mailing Address - Country:US
Mailing Address - Phone:734-782-3500
Mailing Address - Fax:734-782-0938
Practice Address - Street 1:26500 W HURON RIVER DR
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:MI
Practice Address - Zip Code:48134-1135
Practice Address - Country:US
Practice Address - Phone:734-782-3500
Practice Address - Fax:734-782-0938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty