Organization
BURTON ADVANCE DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS J. NIVISON D.D.S. (PRESIDENT)
(810) 742-6600
Entity
Organization
Contact information
Practice address
5492 LAPEER RD, BURTON, MI 48509-2235
(810) 742-6600
(810) 742-5075
Mailing address
5492 LAPEER RD, BURTON, MI 48509-2235
(810) 742-6600
(810) 742-5075
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14588
MI
Other
Enumeration date
12/10/2009
Last updated
12/10/2009
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