Provider Demographics
NPI:1801637111
Name:E&N GREATER MACK PRACTICES PLLC
Entity type:Organization
Organization Name:E&N GREATER MACK PRACTICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-288-3588
Mailing Address - Street 1:23800 GREATER MACK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1406
Mailing Address - Country:US
Mailing Address - Phone:586-775-6320
Mailing Address - Fax:
Practice Address - Street 1:23800 GREATER MACK AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1406
Practice Address - Country:US
Practice Address - Phone:586-775-6320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental