Organization
FOREST DENTAL ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH E FOREST JR. D.D.S. (SOLE MBR)
(586) 739-1210
Entity
Organization
Contact information
Practice address
45100 STERRITT ST., SUITE 101, UTICA, MI 48317-5846
(586) 739-1210
Mailing address
45100 STERRITT ST., SUITE 101, UTICA, MI 48317-5846
(586) 739-1210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14528
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E74280
EIN 80-0730168
MI
Enumeration date
06/11/2015
Last updated
01/05/2016
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