# KEVIN J POTOCSKY, DDS,PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023617289
- **Authorized official:** JANIS DENISE BOEDY (TREATMENT COORDINATOR)
- **Authorized official phone:** (313) 381-1633

## Contact information

- **Practice address:** 7720 ALLEN RD, ALLEN PARK, MI 48101-1928
- **Practice address phone:** (313) 381-1633
- **Practice address fax:** (313) 381-2504
- **Mailing address:** 7720 ALLEN RD, ALLEN PARK, MI 48101-1928
- **Mailing address phone:** (313) 381-1633
- **Mailing address fax:** (313) 381-2504

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 10/20/2020
- **Last updated:** 10/20/2020