Organization
PLYMOUTH ARDENT
Active
Other names
Plymouth Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA BURKEEN (MANAGER)
(734) 459-7110
Entity
Organization
Contact information
Practice address
40400 ANN ARBOR RD E STE 103, PLYMOUTH, MI 48170-4590
(734) 459-7110
(734) 459-0314
Mailing address
40400 ANN ARBOR RD E STE 103, PLYMOUTH, MI 48170-4590
(734) 459-7110
(734) 459-0314
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053768432
NPI
MI
01
—
1245760040
NPI
MI
01
—
1710930581
NPI
MI
Enumeration date
02/12/2020
Last updated
02/12/2020
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