# RENAISSANCE ENDODONTICS, PLLC

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

## Provider details

- **NPI number:** 1174557482
- **Authorized official:** MR. YAKOV YOUNG (OFFICE MANAGER)
- **Authorized official phone:** (248) 395-9800

## Contact information

- **Practice address:** 23077 GREENFIELD RD, SUITE 285, SOUTHFIELD, MI 48075-3709
- **Practice address phone:** (248) 395-9800
- **Practice address fax:** (248) 395-9778
- **Mailing address:** PO BOX 87068, CANTON, MI 48187-0068
- **Mailing address phone:** (248) 395-9800
- **Mailing address fax:** (248) 395-9778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 08/22/2020