Organization
MICHIGAN IMPLANTS & PERIODONTICS INSTITUTE, P.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY MISCH D.D.S., M.S. (MANAGER)
(734) 975-1743
Entity
Organization
Contact information
Practice address
2755 CARPENTER RD, SUITE 2NE, ANN ARBOR, MI 48108-1186
(734) 975-1743
Mailing address
2755 CARPENTER RD, SUITE 2NE, ANN ARBOR, MI 48108-1186
(734) 975-1743
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
2901018946
MI
1223P0300X
Periodontics
Primary
2901019093
MI
Other
Enumeration date
01/19/2009
Last updated
01/19/2009
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