Individual
DR. HOWARD PAUL POTOCSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
17128 FORT ST, RIVERVIEW, MI 48192-6619
(734) 281-3200
(734) 281-3890
Mailing address
17128 FORT ST, RIVERVIEW, MI 48192-6619
(734) 281-3200
(734) 281-3890
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18547
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4462818
—
MI
01
—
J172880
BLUE CROSS BLUE SHIELD
MI
Enumeration date
06/22/2005
Last updated
09/10/2007
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