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Organization
THEODORE L. DEGENHARDT III , D.D.S ., P.C .
Active
Organization
THEODORE L. DEGENHARDT III , D.D.S ., P.C .
Active
Other names
Degenhardt Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE L. DEGENHARDT III DDS (OWNER)
(248) 643-6551
Entity
Organization
Contact information
Practice address
2877 CROOKS RD STE A, TROY, MI 48084-4717
(248) 643-6551
(248) 539-3538
Mailing address
2877 CROOKS RD STE A, TROY, MI 48084-4717
(248) 643-6551
(248) 539-3538
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
10/05/2023
Last updated
11/20/2023
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