Organization
PROVIDENT DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN JEFFREY KESSLER D.D.S. (SECRETARY)
(248) 471-0345
Entity
Organization
Contact information
Practice address
40105 GRAND RIVER AVE, SUITE 1, NOVI, MI 48375-2170
(248) 471-0345
(248) 471-0671
Mailing address
40105 GRAND RIVER AVE, SUITE 1, NOVI, MI 48375-2170
(248) 471-0345
(248) 471-0671
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12 2753487
—
MI
Enumeration date
07/05/2006
Last updated
07/23/2008
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