Organization
COMMERCE PERIODONTOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON SOUYIAS DDS (MEMBER)
(248) 242-6277
Entity
Organization
Contact information
Practice address
2600 UNION LAKE RD, SUITE 130, COMMERCE TOWNSHIP, MI 48382-3588
(248) 242-6277
Mailing address
2600 UNION LAKE RD, SUITE 130, COMMERCE TOWNSHIP, MI 48382-3588
(248) 242-6277
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2901019200
MI
Other
Enumeration date
04/15/2010
Last updated
04/15/2010
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