# ROYAL OAK FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1417907312
- **Authorized official:** MR. DANIEL GERGORY COSTELLO (OFFICE MANAGER)
- **Authorized official phone:** (248) 543-7070

## Contact information

- **Practice address:** 28 OAKLAND PARK BLVD, PLEASANT RIDGE, MI 48069-1109
- **Practice address phone:** (248) 543-7070
- **Practice address fax:** (248) 543-3520
- **Mailing address:** 1200 S WASHINGTON AVE, ROYAL OAK, MI 48067-3222
- **Mailing address phone:** (248) 543-7070
- **Mailing address fax:** (248) 543-3520

## Taxonomy

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

## Other

- **Enumeration date:** 05/11/2006
- **Last updated:** 08/22/2020