# ADIRAM FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295113165
- **Authorized official:** DR. RAMAKRISHNA NALLAPANENI DDS (OWNER)
- **Authorized official phone:** (586) 468-0983

## Contact information

- **Practice address:** 253 S GRATIOT AVE, MOUNT CLEMENS, MI 48043-2425
- **Practice address phone:** (586) 468-0983
- **Practice address fax:** (586) 468-9661
- **Mailing address:** 253 S GRATIOT AVE, MOUNT CLEMENS, MI 48043-2425
- **Mailing address phone:** (586) 468-0983
- **Mailing address fax:** (586) 468-9661

## Taxonomy

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

## Other

- **Enumeration date:** 05/12/2015
- **Last updated:** 09/29/2016