Organization
DENTAL ADMIN CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH THAYIL (OWNER)
(954) 655-6368
Entity
Organization
Contact information
Practice address
32905 W 12 MILE RD, FARMINGTON HILLS, MI 48334-3342
(586) 855-1475
Mailing address
17716 MAISONS DR, CLINTON TWP, MI 48038-3801
(954) 655-6368
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223D0001X
Public Health Dentistry
—
—
1223D0004X
Dental Anesthesiology
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
126900000X
Dental Laboratory Technician
—
—
Other
Enumeration date
02/07/2023
Last updated
02/08/2023
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