Organization
ORTHODONTIC SPECIALISTS LTD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONEI RODOLFO IACOBELLE DDS (PRESIDENT)
(248) 625-2515
Entity
Organization
Contact information
Practice address
5647 SASHABAW RD, CLARKSTON, MI 48346
(248) 625-2515
(248) 625-2297
Mailing address
5647 SASHABAW RD, CLARKSTON, MI 48346
(248) 625-2515
(248) 625-2297
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12807
MI
Other
Enumeration date
01/08/2007
Last updated
08/22/2020
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