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Organization
PREFERRED DENTAL PRACTICE, PC
Active
Organization
PREFERRED DENTAL PRACTICE, PC
Active
Other names
Nicholas Thomas DDS & Robert Shore DDS, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY GERRIT DEMEULENAERE DDS (GENERAL DENTIST/PRESIDENT)
(586) 772-2090
Entity
Organization
Contact information
Practice address
24901 KELLY RD, EASTPOINTE, MI 48021-1367
(586) 772-2090
(586) 772-0742
Mailing address
24901 KELLY RD, EASTPOINTE, MI 48021-1367
(586) 772-2090
(586) 772-0742
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
10/02/2006
Last updated
07/31/2024
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