# ORCHARD-TWELVE DENTAL CENTER PC

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

## Provider details

- **NPI number:** 1487829743
- **Authorized official:** MRS. BETTY J BANKS CDA, RDA (OFFICE MANAGER)
- **Authorized official phone:** (248) 865-0065

## Contact information

- **Practice address:** 27970 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48334-3767
- **Practice address phone:** (248) 865-0065
- **Practice address fax:** (248) 865-7898
- **Mailing address:** 27970 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48334-3767
- **Mailing address phone:** (248) 865-0065
- **Mailing address fax:** (248) 865-7898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 17467 | MI | Yes |

## Other

- **Enumeration date:** 04/28/2008
- **Last updated:** 07/29/2008