# SEVA DENTAL MICHIGAN PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Livonia Dental Team
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124882089
- **Authorized official:** KELLY ROLNICKI (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (708) 372-4773

## Contact information

- **Practice address:** 15875 MIDDLEBELT RD STE 100, LIVONIA, MI 48154-3885
- **Practice address phone:** (734) 427-9871
- **Mailing address:** 2692 RUMINANT RD, PARK CITY, UT 84060-7500

## Taxonomy

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

## Other

- **Enumeration date:** 02/12/2024
- **Last updated:** 02/12/2024