# DETROIT DENTAL RX PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1053254193
- **Authorized official:** ALEX WOLICKI (MEMBER)
- **Authorized official phone:** (586) 558-8004

## Contact information

- **Practice address:** 15510 LIVERNOIS AVE, DETROIT, MI 48238-1343
- **Practice address phone:** (313) 217-0014
- **Practice address fax:** (313) 246-1886
- **Mailing address:** 27201 RYAN RD, WARREN, MI 48092-5127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 04/13/2026
- **Last updated:** 04/13/2026