Organization
PGS D-PROVIDER DENTISTRY PLLC
Active
Parent organization
PGS D-PROVIDER DENTISTRY PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PGS D-PROVIDER DENTISTRY PLLC
Authorized official
SANDI BARNES (OFFICE MANAGER)
(586) 727-3815
Entity
Organization
Contact information
Practice address
1616 GRATIOT BLVD, MARYSVILLE, MI 48040-1181
(586) 727-3815
Mailing address
1616 GRATIOT BLVD, MARYSVILLE, MI 48040-1181
(586) 727-3815
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/14/2020
Last updated
05/14/2020
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