# KACY FAMILY DENTISTRY, PC

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

## Provider details

- **NPI number:** 1316084379
- **Authorized official:** DONALD R KACY DDS (DENTIST)
- **Authorized official phone:** (248) 879-2980

## Contact information

- **Practice address:** 77 W SQUARE LAKE RD, TROY, MI 48098-2929
- **Practice address phone:** (248) 879-2980
- **Practice address fax:** (248) 879-2983
- **Mailing address:** 77 W SQUARE LAKE RD, TROY, MI 48098-2929
- **Mailing address phone:** (248) 879-2980
- **Mailing address fax:** (248) 879-2983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901011072 | MI | Yes |
| 1223G0001X | General Practice Dentistry | 2901017998 | MI | — |

## Other

- **Enumeration date:** 01/31/2007
- **Last updated:** 04/02/2014