Individual
RICHARD TACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7650 DIXIE HWY, SUITE 120, CLARKSTON, MI 48346-2078
(248) 625-1769
Mailing address
7650 DIXIE HWY, SUITE 120, CLARKSTON, MI 48346-2078
(248) 625-1769
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901012344
MI
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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