Provider Demographics
NPI:1841440245
Name:PEARL DENTAL P.C.
Entity type:Organization
Organization Name:PEARL DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHETANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KARANTH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-476-4416
Mailing Address - Street 1:50364 LIVINGSTON DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-6802
Mailing Address - Country:US
Mailing Address - Phone:248-476-4416
Mailing Address - Fax:248-679-8889
Practice Address - Street 1:33566 W 8 MILE RD STE B
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-5271
Practice Address - Country:US
Practice Address - Phone:248-476-4416
Practice Address - Fax:248-679-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty