# DAVID R BACKUS DDS

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

## Provider details

- **NPI number:** 1194127258
- **Authorized official:** DR. DAVID RICHARD BACKUS DDS (OWNER)
- **Authorized official phone:** (248) 683-8188

## Contact information

- **Practice address:** 4633 DOW RIDGE RD, ORCHARD LAKE, MI 48324-2326
- **Practice address phone:** (248) 683-8188
- **Mailing address:** 4633 DOW RIDGE RD, ORCHARD LAKE, MI 48324-2326
- **Mailing address phone:** (248) 683-8188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901012277 | MI | Yes |

## Other

- **Enumeration date:** 09/20/2014
- **Last updated:** 09/20/2014